A number of ethical questions are concerned with the endpoints of the human life span. The question of whether abortion or the use of human embryos as sources of stem cells can be morally justified was exhaustively discussed in popular contexts, where the answer was often taken to depend directly on the answer to the further question: “When does human life begin?” Many philosophers...

...share a common advantage: they need not be preceded by a definition of death. They accept death as an easily determined empirical fact, not requiring discussion or further elaboration. But a conceptual crisis has arisen in modern medicine and biology, a crisis that stems precisely from the realization that the definition of death—taken for granted for millennia—requires...

...charges may result in threats of thawing and putrefaction. In a contentious environment, the law has even invaded the intensive care unit, influencing the decisions of physicians concerning the withdrawal of treatment or the determination of death. A wit has remarked that in the modern era, the only sure sign that a man is dead is that he is no longer capable of litigation.

Our genetic constitution contributes to making us not only what we are—tall or short, male or female, healthy or sick—but also who we are, how we think and feel. Furthermore, although we generally like to think of our genomes as being uniquely ours, in fact we share significant aspects of them with our families, and information about our own genes is also information about our loved...

In the 1960s, American legal philosopher Lon Fuller distinguished between “the morality of...

Although in modern times the practice of veterinary medicine has been separated from that of human medicine, the observations of the physician and the veterinarian continue to add to the common body of medical knowledge. Of the more than 1,200,000 species of animals thus far identified, only a few have been utilized in research, even though it is likely that, for every known human disease, an...

Meanwhile, the increasingly systemic and brutal abuses of animals in modern society—by the billions on factory farms and by the tens of millions in biomedical-research laboratories—spawned thousands of animal rights groups. Some consisted of a mere handful of people interested in local, and more traditional, animal-protection issues, such as animal shelters that care for stray dogs...

Long-term medical research is being conducted to investigate the possibility of developing vaccines and supplements that, when administered, might raise the effectiveness of the recipient’s immune system to protect against the whole spectrum of probable biological weapon agents.

The remarkable developments in medicine that have been brought about in the 20th century, especially since World War II, have been based on research either in the basic sciences related to medicine or in the clinical field. Advances in the use of radiation, nuclear energy, and space research have played an important part in this progress. Some laypersons often think of research as taking place...

...have the same professional rights and responsibilities as do holders of the M.D. degree in most states. In most cases, physicians of both schools of...

The obvious alternative to general practice is the direct access of a patient to a specialist. If a patient has problems with vision, he goes to an eye specialist, and if he has a pain in his chest (which he fears is due to his heart), he goes to a heart specialist. One objection to this plan is that the patient often cannot know which organ is responsible for his symptoms, and the most careful...

At the beginning of World War II it was possible to recognize a number of major medical specialties, including internal medicine, obstetrics and gynecology, pediatrics, pathology, anesthesiology, ophthalmology, surgery, orthopedic surgery, plastic surgery, psychiatry and neurology, radiology, and urology. Hematology was also an important field of study, and microbiology and biochemistry were...

The increasing scope of surgery led to specialization. Admittedly, most general surgeons had a special interest, and for a long time there had been an element of specialization in such fields as ophthalmology, orthopedics, obstetrics, and gynecology; but before long it became apparent that, to achieve progress in certain areas, surgeons had to concentrate their attention on that particular...

The most widely used classifications of disease are (1) topographic, by bodily region or system, (2) anatomic, by organ or tissue, (3) physiological, by function or effect, (4) pathological, by the nature of the disease process, (5) etiologic (causal), (6) juristic, by speed of advent of death, (7) epidemiological, and (8) statistical. Any single disease may fall within several of these...

...measures and facilities unavailable elsewhere in the...

An even more dramatic result of the growth in chemical knowledge has been the expansion of the modern pharmaceutical industry. The science of pharmacy emerged slowly from the traditional empiricism of the herbalist, but by the end of the 19th century there had been some solid achievements in the analysis of existing drugs and in the preparation of new ones. The discovery in 1856 of the first...

The second half of the 20th century has seen tremendous developments in the field of intensive care and the emergence of new controversies concerning the point of no return. Modern technology now makes it possible to maintain ventilation (by respirators), cardiac function (by various pumping devices), feeding (by the intravenous route), and the elimination of the waste products of metabolism...

...and the advances of modern surgery and medicine have been achieved at a certain price. A mechanistic approach has developed, in which the protraction of dying has become a major by-product of modern technology. The philosophy of modern medicine has been diverted from attention to the sick and has begun to reify the sickness. Instead of perceiving death as something natural, modern...

The treatment of many human disease conditions requires surgical intervention in order to assist, augment, sustain, or replace a diseased organ, and such procedures involve the use of materials foreign to the body. These materials, known as biomaterials, include synthetic polymers and, to a lesser extent, biological polymers, metals, and ceramics. Specific applications of biomaterials range...

These are the most complex and controversial of welfare and security programs. Benefits may include indemnification for lost wages in addition to medical treatment. Coverage ranges from universal down to only those employed by participating employers. Financing may be contributory or governmental, depending in particular upon the method of providing service in a given country. Medical care may...

Four classes of benefits are provided by compulsory insurance, and, except for certain diseases, a right to them is acquired without any qualifying period of previous employment. First is a medical benefit, which includes all necessary treatment and the supply of artificial limbs. If its duration is limited, the maximum is likely to be one year. Second is a temporary incapacity benefit, which...

...elixirs for metal ennoblement and for the preservation of health. His successors multiplied elixirs, which lost their uniqueness and finally simply became new medicines, often for specific ailments. Medical chemistry may have been conceived under Islām, but it was born in Europe. It only awaited christening by its great publicist, Paracelsus (1493–1541), who was the sworn enemy of...

...however, that the basis of chemistry was in fact laid by alchemy rather than medicine. During the crucial period of Arabic and early Latin alchemy, it appears that innovation owed more to nascent medical chemistry than to alchemy.

The medical history of a patient is the most useful and important element in making an accurate diagnosis, much more valuable than either physical examinations or diagnostic tests. The medical interview is the process of gathering data that will lead to an understanding of the disease and the underlying physiological process. To be effective, an interviewer must possess good communication...

Health insurance may apply to a limited or comprehensive range of medical services and may provide for full or partial payment of the costs of specific services. Benefits may consist of the right to certain medical services or reimbursement to the insured for specified medical costs. Some types of health insurance may also include income benefits for working time lost because of sickness (i.e.,...

The medical services of armies, navies, and air forces are geared to war. During campaigns the first requirement is the prevention of sickness. In all wars before the 20th century, many more combatants died of disease than of wounds. And even in World War II and wars thereafter, although few died of disease, vast numbers became casualties from disease.

This is intelligence gained from studying every aspect of foreign natural and man-made environments that could affect the health of military forces. This information can be used not only to predict the medical weaknesses of an enemy but also to provide one’s own forces with adequate medical protection. For example, in the Spanish-American War the majority of U.S. casualties in the Caribbean...

Medicine and the law do not always work in harmony. The most common source of conflict is medical confidentiality. Some doctors claim that any information received from a patient during a medical consultation is subject ethically to absolute confidentiality and can in no circumstances be revealed without the patient’s permission. Without such a rule, they believe, patients sometimes would not...

Medical anthropology emerged as a special field of research and training after World War II, when senior American anthropologists were brought in as consultants on health care projects in Latin America, Asia, and Africa. In the Cold War rhetoric of the time, aid to friendly “Third World countries” would strengthen their governments and forestall revolutionary discontent. In these...

...investigations using census and other data are complemented by detailed case studies of decision making, such as whether and where to migrate and how relevant information is received and processed. Medical geography focuses on patterns of disease and death—of how diseases spread, for example, and how variations in morbidity and mortality rates reflect local environments—and on...

Despite the dropping of the term eugenics, eugenic ideas remain prevalent in many issues surrounding human reproduction. Medical genetics, a post-World War II medical specialty, encompasses a wide range of health concerns, from genetic screening and counseling to fetal gene manipulation and the treatment of adults suffering from hereditary disorders. Because certain diseases (e.g.,...

Medical engineering. Medical engineering concerns the application of engineering principles to medical problems, including the replacement of damaged organs, instrumentation, and the systems of health care, including diagnostic applications of computers.Agricultural engineering. This includes the application of engineering principles to the problems of biological production and...

...School of Medicine. In 1978 he became a member of the pathology and biochemistry faculty at Columbia, where in the early 1980s Buck worked under him as a postdoctoral student. Axel joined the Howard Hughes Medical Institute (HHMI) as an investigator in 1984.

...Center. She first worked with Axel in the early 1980s at Columbia University in New York City, where Axel was a professor and Buck was his postdoctoral student. Buck held various positions with the Howard Hughes Medical Institute (HHMI) and at Harvard Medical School from 1984 until 2002, when she joined the Fred Hutchinson Cancer Research Center in Seattle.

...payments may be subsidized by their employer, with the money going into a special fund. Insurance of hospital costs is the most prevalent form of private health insurance coverage; another type is major medical expense protection, which provides protection against large medical costs but avoids the financial and administrative burdens involved in insuring small costs.

Antipoverty programs and the system of personal taxation may also be regarded as aspects of the welfare state. Personal taxation falls into this category insofar as its progressivity is used to achieve greater justice in income distribution (rather than merely to raise revenue) and also insofar as it used to finance social insurance payments and other benefits not completely financed by...

...up to a maximum for each type of operation. Regular medical insurance contracts indemnify the insured for expenses such as physicians’ home or office visits, medicines, and other medical expenses. Major medical contracts are distinguished from other health insurance policies by offering coverage without many specific limitations; usually there is only a maximum per person, a deductible...

...The new direction in medical education was aided in Britain by the passage of the Medical Act of 1858, which has been termed the most important event in British medicine. It established the General Medical Council, which thenceforth controlled admission to the medical register and thus had great powers over medical education and examinations. Further interest in medicine grew from these...

...Medical Education and the Liaison Committee on Medical Education, both affiliates of the American Medical Association, and the American Osteopathic Association. In Britain the statutory body is the General Medical Council, most of whose members are from the profession, although only a minority of the members are appointed by it. In other countries medical education may be regulated by an office...

American physician and educator, whose leadership engendered a notable increase in quality and course offerings at the Women’s Medical College.

...later, having completed her apprenticeship, Preston was refused admission to all four Philadelphia medical colleges because of her sex. In October 1850, however, she entered the newly established Female (later Woman’s) Medical College of Pennsylvania with the first class, and she graduated in 1851. After further study she was appointed professor of physiology and hygiene at the college in...

...Cell Center, and UCLA’s School of Public Health. He returned to Morehouse in 1979 to chair the department of community medicine and family practice, and from 1982 to 1993 he served as president of Meharry Medical College in Nashville, Tennessee. When Satcher assumed the presidency, Meharry, dedicated to training African American doctors for 100 years, was on the verge of losing its...

Wayne State University was formed in 1933 from the merger of several established colleges in Detroit. The oldest of these antecedents was the Detroit Medical College, founded in 1868 and now the School of Medicine. Detroit Teachers College (founded 1881) and the College of the City of Detroit (founded 1917) were also important antecedents of Wayne State. After the merger, the university was...

A group of physicians led by George McClellan created Jefferson Medical College in Philadelphia in 1824. It served as the medical department of Jefferson College (then located in Canonsburg) until the state granted the medical college an independent charter in 1838. In 1877 it opened one of the first teaching hospitals in the United States. In 1969 Jefferson Medical College became part of...

In 1962 the Medical Research Council opened its new laboratory of molecular biology in Cambridge. The Austrian-born British biochemist Max Perutz, British biochemist John Kendrew, and British biophysicist Francis Crick moved to the new laboratory. Sanger joined them as head of the protein division. It was a banner year for the group, as Perutz and Kendrew shared the 1962 Nobel Prize for...

In 1891 Murray published his most important research, a report in the British Medical Journal on the effectiveness of sheep thyroid extract in treating myxedema in humans. Thyroid deficiency had been recognized as the cause of myxedema in the 1880s, and several researchers had established that an animal could survive the usually fatal effects of thyroidectomy if part of the excised...

There are two main types of HMOs, the prepaid group practice model and the medical care foundation (MCF), also called individual practice association. The prepaid group practice type of health care plan was pioneered by the Ross-Loos Medical Group in California, U.S., in 1929. In this model, physicians are organized into a group practice, and there is one insuring agency. The Kaiser Foundation...

The Hadassah Medical Centre at ʿEn Kerem, one of the most advanced institutions of its kind in the world, treats patients from throughout Israel, as well as from the West Bank, the Gaza Strip, and Jordan, as does the Hadassah Hospital on Mount Scopus. Other hospitals include Shaʿare Tzedeq, which pays special attention to the requirements of Orthodox Jews; Biqur Ḥolim; St....

A comprehensive national health service and national medical insurance were created in 1978 and based on Local Medical Units (Unità Sanitarie Locali, USL; later renamed Aziende Sanitarie Locali, ASL). In 1992–99 a radical reorganization of the national health system was carried out. Key features of the new system were the rationalization of public expenditures and the improvement...

...and maximum allowances for room and board. Surgical expense insurance covers the surgeon’s charge for given operations or medical procedures, usually up to a maximum for each type of operation. Regular medical insurance contracts indemnify the insured for expenses such as physicians’ home or office visits, medicines, and other medical expenses. Major medical contracts are distinguished from...

...prominence. Other examples include the three major medical associations in Great Britain: the Royal College of Physicians of London, the Royal College of Surgeons of England, and the British Medical Association (BMA). The latter association, formed in 1832, initially represented rural physicians and specifically excluded London doctors or those associated with the Royal...

...the antioxidants and stabilizers that prevent premature oxidative degradation of polyetherurethanes. Other additives, such as pigments, can be eliminated from biomedical products. Indeed, a “medical-grade” biomaterial is one that has had nonessential additives and potential contaminants excluded or eliminated from the polymer. In order to achieve this grade, the polymer may need to...

...almoner has also been used in Britain for a trained social worker, usually a woman, qualified to work in a medical setting. In this sense “almoner” was superseded in 1964 by the title medical social worker, the term also used in the United States. Medical social workers are employed by hospitals and public health departments.

...in relation to his solid and liquid excretions. After 30 years of continuous experimentation, he found that the sum total of visible excreta was less than the amount of substance ingested. His De Statica Medicina (1614; “On Medical Measurement”) was the first systematic study of basal metabolism.

...education for women had advanced and nurses’ training had begun; the vast majority of Indian nurses also have been Christian. The education of women physicians began at the turn of the century. The Vellore Medical College is a monument to the missionary physician Ida Scudder (1870–1959).

...applied specifically to highly trained persons who share with physicians the direct responsibility for patient care. This category includes nurse practitioners, physician’s assistants, and emergency medical technicians. These paramedical workers perform routine diagnostic procedures, such as the taking of blood samples, and therapeutic procedures, such as administering injections or...

...in medical education and practice, science, and ethics. The medical association also works to promote and protect the interests of its physician members. The largest such organization is the World Medical Association, which has more than 60 member associations. It was founded in 1947.

...pays for damage to the insured car if it collides with another vehicle or object; comprehensive insurance pays for damage to the insured car resulting from fire or theft or many other causes; medical-payment insurance covers medical treatment for the policyholder and his passengers.

the most famous group of physicians in the United States. Three generations of the Mayo family, pioneers in the practice of group medicine, established the world-renowned Mayo Clinic and the Mayo Foundation for Medical Education and Research at Rochester, Minn.

...Head, an early settler who had lived there for a time. Rochester’s growth was stimulated in 1889 by the opening by William Worrall Mayo and his sons (see Mayo family) of what would evolve into the Mayo Medical Center, and it is now one of the state’s largest cities. Severe flooding in 1978 prompted a flood-control project that continued into the 1990s.

The Twin Cities and Rochester serve as national health care centres. The Mayo Clinic in Rochester has served patients from around the world since the late 19th century. The University of Minnesota Hospitals in the Twin Cities area has been a pioneer in medical research, while numerous hospitals across the state provide an effective network of medical care.

...clinic the relationship between each physician and the organization must be defined in a legal agreement. The relationship usually takes the form of a partnership. Several of these, such as the Mayo Clinic, in Rochester, Minn., have achieved a national reputation and attract patients from a wide area. Most of these organized group clinics are general clinics—i.e., they have...

...programs, CARE organizes a number of projects, including land management, soil conservation, food distribution, nutrition, and nutrition education. Since 1962, CARE’s services also have included the Medical International Cooperation Organization (MEDICO; founded 1958), which gives health care workers training for service to remote rural areas.

...and book sales to establish a small hospital in Nam Tha, northern Laos. After another American lecture tour and the publication of The Edge of Tomorrow (1958), Dooley helped found the Medical International Corporation (Medico) to provide medical teams and hospital facilities in eight less-developed nations, most of them in Southeast Asia.

...Washington, D.C. (1864–95), Billings developed the library later known as the Army Medical Library. Under successive directors it grew into the Surgeon General’s Library and ultimately the National Library of Medicine, the world’s largest medical reference centre. His attempt to construct a logical classification system for the library resulted in his founding of the Index...

...university began in 1787, in a three-room log schoolhouse, as Pittsburgh Academy. In 1819 it became the Western University of Pittsburgh. The School of Medicine, originally chartered in 1886 as the Western Pennsylvania Medical College, joined the university in 1892. The school’s name was changed to the University of Pittsburgh in 1908. The central feature of the main campus is its Cathedral of...

...of HMOs, the prepaid group practice model and the medical care foundation (MCF), also called individual practice association. The prepaid group practice type of health care plan was pioneered by the Ross-Loos Medical Group in California, U.S., in 1929. In this model, physicians are organized into a group practice, and there is one insuring agency. The Kaiser Foundation Health Plan in California,...

public, coeducational institution of higher learning in Richmond, Virginia, U.S. It comprises the College of Humanities and Sciences and 12 other schools, including the School of Medicine on the Medical College of Virginia campus (also in Richmond). The university offers a broad range of undergraduate, graduate, and professional degree programs in such areas as business, dentistry, education,...

...position and moved with him to Washington, D.C. In 1984, having suffered from a series of miscarriages and feeling alienated in Washington, she moved back to Arizona. In 1988 she founded the American Voluntary Medical Team (AVMT), a nonprofit organization that provided medical care to people in impoverished and war-ravaged countries throughout the world. Cindy herself led more than 50...

...Medical Examiners holds examinations leading to a degree that is acceptable to most state boards. National laws regulating professional practice cannot be enacted in the United States. In Canada the Medical Council of Canada conducts examinations and enrolls successful candidates on the Canadian medical register, which the provincial governments accept as the main requirement for licensure. In...