David J. Rothman – författare

The Willowbrook Wars is a dramatic and illuminating account of the effort to close down a scandal-ridden institution and return its 5,400 handicapped residents to communities in New York. The wars began in 1972 with Geraldo Rivera''s televised raid on the Willowbrook State School. They continued for three years in a federal courtroom, with civil libertarian lawyers persuading a conservative and conscience-stricken judge to expand the rights of the disabled, and they culminated in a 1975 consent decree, with the state of New York pledging to accomplish the unprecedented assignment in six years.

From 1975 to 1982, David and Sheila Rothman observed this remarkable chapter in American reform of mental disabilities care. Would the state live up to its agreement without "dumping" residents into other nightmarish institutions? Would the lawyers prove as interested in meeting client needs as in securing client rights? Could a tradition-bound bureaucracy create a new network of community services? And finally, would a governor and a legislature tolerate such outside intervention, and if so, for how long? In answering these questions,

The Willowbrook Wars takes us behind the scenes to clarify the role of the judiciary, the fate of the underprivileged, and the potential for social justice. In their new afterword, the authors bring the story up to date, describing the results of the closing of the institution in 1987 from the experiences of integrating the former residents into communities to the legal battles between the state of New York and advocates for the mentally handicapped.

The Willowbrook Wars is a dramatic and illuminating account of the effort to close down a scandal-ridden institution and return its 5,400 handicapped residents to communities in New York. The wars began in 1972 with Geraldo Rivera''s televised raid on the Willowbrook State School. They continued for three years in a federal courtroom, with civil libertarian lawyers persuading a conservative and conscience-stricken judge to expand the rights of the disabled, and they culminated in a 1975 consent decree, with the state of New York pledging to accomplish the unprecedented assignment in six years.

From 1975 to 1982, David and Sheila Rothman observed this remarkable chapter in American reform of mental disabilities care. Would the state live up to its agreement without "dumping" residents into other nightmarish institutions? Would the lawyers prove as interested in meeting client needs as in securing client rights? Could a tradition-bound bureaucracy create a new network of community services? And finally, would a governor and a legislature tolerate such outside intervention, and if so, for how long? In answering these questions,

The Willowbrook Wars takes us behind the scenes to clarify the role of the judiciary, the fate of the underprivileged, and the potential for social justice. In their new afterword, the authors bring the story up to date, describing the results of the closing of the institution in 1987 from the experiences of integrating the former residents into communities to the legal battles between the state of New York and advocates for the mentally handicapped.

David Rothman gives us a brilliant, finely etched study of medical practice today. Beginning in the mid-1960s, the practice of medicine in the United States underwent a most remarkable--and thoroughly controversial--transformation. The discretion that the profession once enjoyed has been increasingly circumscribed, and now an almost bewildering number of parties and procedures participate in medical decision making.

Well into the post-World War II period, decisions at the bedside were the almost exclusive concern of the individual physician, even when they raised fundamental ethical and social issues. It was mainly doctors who wrote and read about the morality of withholding a course of antibiotics and letting pneumonia serve as the old man''s best friend, of considering a newborn with grave birth defects a "stillbirth" thus sparing the parents the agony of choice and the burden of care, of experimenting on the institutionalized the retarded to learn more about hepatitis, or of giving one patient and not another access to the iron lung when the machine was in short supply. Moreover, it was usually the individual physician who decided these matters without formal discussions with patients, their families, or even with colleagues, and certainly without drawing the attention of journalists, judges, or professional philosophers.

The impact of the invasion of outsiders into medical decision-making, most generally framed, was to make the invisible visible. Outsiders to medicine--that is, lawyers, judges, legislators, and academics--have penetrated its every nook and cranny, in the process giving medicine exceptional prominence on the public agenda and making it the subject of popular discourse. The glare of the spotlight transformed medical decision making, shaping not merely the external conditions under which medicine would be practiced (something that the state, through the regulation of licensure, had always done), but the very substance of medical pract

David Rothman gives us a brilliant, finely etched study of medical practice today. Beginning in the mid-1960s, the practice of medicine in the United States underwent a most remarkable--and thoroughly controversial--transformation. The discretion that the profession once enjoyed has been increasingly circumscribed, and now an almost bewildering number of parties and procedures participate in medical decision making.

Well into the post-World War II period, decisions at the bedside were the almost exclusive concern of the individual physician, even when they raised fundamental ethical and social issues. It was mainly doctors who wrote and read about the morality of withholding a course of antibiotics and letting pneumonia serve as the old man''s best friend, of considering a newborn with grave birth defects a "stillbirth" thus sparing the parents the agony of choice and the burden of care, of experimenting on the institutionalized the retarded to learn more about hepatitis, or of giving one patient and not another access to the iron lung when the machine was in short supply. Moreover, it was usually the individual physician who decided these matters without formal discussions with patients, their families, or even with colleagues, and certainly without drawing the attention of journalists, judges, or professional philosophers.

The impact of the invasion of outsiders into medical decision-making, most generally framed, was to make the invisible visible. Outsiders to medicine--that is, lawyers, judges, legislators, and academics--have penetrated its every nook and cranny, in the process giving medicine exceptional prominence on the public agenda and making it the subject of popular discourse. The glare of the spotlight transformed medical decision making, shaping not merely the external conditions under which medicine would be practiced (something that the state, through the regulation of licensure, had always done), but the very substance of medical pract

Conscience and Convenience was quickly recognized for its masterly depiction and interpretation of a major period of reform history. This history begins in a social context in which treatment and rehabilitation were emerging as predominant after America''s prisons and asylums had been broadly acknowledged to be little more than embarrassing failures. The resulting progressive agenda was evident: to develop new, more humane and effective strategies for the criminal, delinquent, and mentally ill. The results, as Rothman documents, did not turn out as reformers had planned.

For adult criminal offenders, such individual treatment could be accomplished only through the provision of broad discretionary authority, whereby choices could be made between probation, parole, indeterminate sentencing, and, as a measure of last resort, incarceration in totally redesigned prisons. For delinquents, the juvenile court served as a surrogate parent and accelerated and intensified individual treatment by providing for a series of community-based individual and family services, with the newly designed, school-like reformatories being used for only the most intractable cases. For the mentally ill, psychiatrists chose between outpatient treatments, short-term intensive care, or as last resort, long-term care in mental hospitals with new cottage and family-like arrangements. Rothman shows the consequences of these reforms as unmitigated disasters. Despite benevolent intentions, the actual outcome of reform efforts was to take the earlier failures of prisons and asylums to new, more ominous heights.

In this updated edition, Rothman chronicles and examines incarceration of the criminal, the deviant, and the dependent in U.S. society, with a focus on how and why these methods have persisted and expanded for over a century and a half despite longstanding evidence of their failures and abuses.

Conscience and Convenience was quickly recognized for its masterly depiction and interpretation of a major period of reform history. This history begins in a social context in which treatment and rehabilitation were emerging as predominant after America''s prisons and asylums had been broadly acknowledged to be little more than embarrassing failures. The resulting progressive agenda was evident: to develop new, more humane and effective strategies for the criminal, delinquent, and mentally ill. The results, as Rothman documents, did not turn out as reformers had planned.

For adult criminal offenders, such individual treatment could be accomplished only through the provision of broad discretionary authority, whereby choices could be made between probation, parole, indeterminate sentencing, and, as a measure of last resort, incarceration in totally redesigned prisons. For delinquents, the juvenile court served as a surrogate parent and accelerated and intensified individual treatment by providing for a series of community-based individual and family services, with the newly designed, school-like reformatories being used for only the most intractable cases. For the mentally ill, psychiatrists chose between outpatient treatments, short-term intensive care, or as last resort, long-term care in mental hospitals with new cottage and family-like arrangements. Rothman shows the consequences of these reforms as unmitigated disasters. Despite benevolent intentions, the actual outcome of reform efforts was to take the earlier failures of prisons and asylums to new, more ominous heights.

In this updated edition, Rothman chronicles and examines incarceration of the criminal, the deviant, and the dependent in U.S. society, with a focus on how and why these methods have persisted and expanded for over a century and a half despite longstanding evidence of their failures and abuses.