David J. Rothman - Böcker

In the wake of the recent unsuccessful drive for health care reform, many people have been asking themselves what brought about the failure of this as well as past attempts to make health care accessible to all Americans. The author of this original exploration of U.S. health policy supplies an answer that is bound to raise some eyebrows. After a careful analysis of the history and issues of health care, David Rothman concludes that it is the average employed, insured "middle class"--the vaguely defined majority of American citizens--who deny health care to the poor.The author advances his argument through the examination of two distinctive characteristics of American health care and the intricate links between them: the ubiquitous presence of technology in medicine, and the fact that the U.S. lacks a national health insurance program. Technology bears the heaviest responsibility for the costliness of American medicine. Rothman traces the histories of the "iron lung" and kidney dialysis machines in order to provide vivid evidence for his claim that the American middle class is fascinated by technology and is willing to pay the price to see the most recent advances in physics, biology, and biomedical engineering incorporated immediately in medical care. On the other hand, the lack of a universal health insurance program in the U.S. is rooted in the fact that, starting in the 1930's, government health policy has been a reflection of the needs and concerns of the middle class. Playing up to middle class sensibilities, the American presidents, Senate and Congress based their policy upon the private rather than the public sector, whenever possible. They encouraged the purchase of insurance based on the laws of the marketplace, not provided by the government. Private health insurance and high-tech medicine came with a hefty price, with the end result that about 40 million Americans could not afford medical care and were left to fend for themselves. The author investigates the moral values underpinning these decisions, and goes to the bottom of the problem of why the United States remain the only developed country which continually proves unable to provide adequate health care to all its citizens.

The Oxford History of the Prison is an informative account of the growth and development of the prison in Western society, from classical times to the present day. In fourteen chapters -- each written by specialists in social, legal, and institutional history -- the book explores not only the complex history of the prison, but also the social world of inmates and their keepers.

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.

This is a masterful effort to recognize and place the prison and asylums in their social contexts. Rothman shows that the complexity of their history can be unraveled and usefully interpreted. By identifying the salient influences that converged in the tumultuous 1820s and 1830s that led to a particular ideology in the development of prisons and asylums, Rothman provides a compelling argument that is historically informed and socially instructive. He weaves a comprehensive story that sets forth and portrays a series of interrelated events, influences, and circumstances that are shown to be connected to the development of prisons and asylums. Rothman demonstrates that meaningful historical interpretation must be based upon not one but a series of historical events and circumstances, their connections and ultimate consequences. Thus, the history of prisons and asylums in the youthful United States is revealed to be complex but not so complex that it cannot be disentangled, described, understood, and applied.This reissue of a classic study addresses a core concern of social historians and criminal justice professionals: Why in the early nineteenth century did a single generation of Americans resort for the first time to institutional care for its convicts, mentally ill, juvenile delinquents, orphans, and adult poor? Rothman's compelling analysis links this phenomenon to a desperate effort by democratic society to instill a new social order as it perceived the loosening of family, church, and community bonds. As debate persists on the wisdom and effectiveness of these inherited solutions, The Discovery of the Asylum offers a fascinating reflection on our past as well as a source of inspiration for a new century of students and professionals in criminal justice, corrections, social history, and law enforcement.

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 practice--the decisions that physicians made at the bedside.

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.

American motion pictures still dominate the world market with an impact that is difficult to measure. Their role in American culture has been a powerful one since the 1930s and is a hallmark of our culture today. Though much has been written about the film industry, there has been very little systematic attention paid to the ideology of its creativ

American motion pictures still dominate the world market with an impact that is difficult to measure. Their role in American culture has been a powerful one since the 1930s and is a hallmark of our culture today. Though much has been written about the film industry, there has been very little systematic attention paid to the ideology of its creative elite. How does the outlook of that elite impact on the portrayals of America that appear on the screen? How do their views interact with the demands of the market and the structure of the industry to determine the product that is seen by mass audiences?Hollywood's America is a marvelously rich and careful discussion of these questions. It combines a meticulous systematic content analysis of fifty years of top-grossing films with a history of the changing structure of the industry. To that mixture it adds an in-depth survey of Hollywood's creative elite, comparing them to other leadership groups. The result is a balanced discussion of unique breadth and depth on a subject of national importance.Placing the film industry in the context of American society as a whole, the authors point out that Hollywood's creative leadership impacts the larger society even as it is influenced by that society. The creators of films cannot remove themselves too far from the values of the audiences that they serve. However, the fact that films are made by a relatively small number of people, who, as the authors demonstrate, tend to share a common outlook, means that, over time, motion pictures have had an undeniable impact on the beliefs, lifestyles, and action of Americans.This study contributes to the debate over the role and influence of those who create and distribute the products of mass culture in the United States.The book also contains a devastating critique of the poststructuralist theories that currently dominate academic film criticism, demonstrating how they fail in their attempt to explain the political significance of motion pictures.

This fabulous anthology is sure to be a core text for history of medicine and social science classes in colleges across the country. In order to demonstrate how medical research has influenced Western cultural perspectives, the editors have collected original works from 61 different authors around nine major themes (among them "Anatomy and Destiny," "Psyche and Soma," and "The Construction of Pain, Suffering, and Death"). The authors range from Aristotle, the Bible, and Louis Pasteur, to Masters and Johnson, Ernest Hemingway, and Simone de Beauvoir. The primary sources selected to illustrate the themes are well chosen and contrast with each other nicely. However, the brief background material for the selections center around the authors and offer little or no discussion about the selections' relevance to the topics at hand. This book would be best read in a class or group where the texts' meaning in relation to each other can be discussed, but the book can stand alone if the reader is prepared to do some critical thinking.

With computerized health information receiving unprecedented government support, a group of health policy scholars analyze the intricate legal, social, and professional implications of the new technology. These essays explore how Health Information Technology (HIT) may alter relationships between physicians and patients, physicians and other providers, and physicians and their home institutions. Patient use of web-based information may undermine the traditional information monopoly that physicians have long enjoyed. New IT systems may increase physicians' legal liability and heighten expectations about transparency. Case studies on kidney transplants and maternity practices reveal the unanticipated effects, positive and negative, of patient uses of the new technology. An independent HIT profession may emerge, bringing another organized interest into the medical arena. Taken together, these investigations cast new light on the challenges and opportunities presented by HIT.

With computerized health information receiving unprecedented government support, a group of health policy scholars analyze the intricate legal, social, and professional implications of the new technology. These essays explore how Health Information Technology (HIT) may alter relationships between physicians and patients, physicians and other providers, and physicians and their home institutions. Patient use of web-based information may undermine the traditional information monopoly that physicians have long enjoyed. New IT systems may increase physicians' legal liability and heighten expectations about transparency. Case studies on kidney transplants and maternity practices reveal the unanticipated effects, positive and negative, of patient uses of the new technology. An independent HIT profession may emerge, bringing another organized interest into the medical arena. Taken together, these investigations cast new light on the challenges and opportunities presented by HIT.

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.

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 practice--the decisions that physicians made at the bedside.

This is a masterful effort to recognize and place the prison and asylums in their social contexts. Rothman shows that the complexity of their history can be unraveled and usefully interpreted. By identifying the salient influences that converged in the tumultuous 1820s and 1830s that led to a particular ideology in the development of prisons and asylums, Rothman provides a compelling argument that is historically informed and socially instructive. He weaves a comprehensive story that sets forth and portrays a series of interrelated events, influences, and circumstances that are shown to be connected to the development of prisons and asylums. Rothman demonstrates that meaningful historical interpretation must be based upon not one but a series of historical events and circumstances, their connections and ultimate consequences. Thus, the history of prisons and asylums in the youthful United States is revealed to be complex but not so complex that it cannot be disentangled, described, understood, and applied.This reissue of a classic study addresses a core concern of social historians and criminal justice professionals: Why in the early nineteenth century did a single generation of Americans resort for the first time to institutional care for its convicts, mentally ill, juvenile delinquents, orphans, and adult poor? Rothman's compelling analysis links this phenomenon to a desperate effort by democratic society to instill a new social order as it perceived the loosening of family, church, and community bonds. As debate persists on the wisdom and effectiveness of these inherited solutions, The Discovery of the Asylum offers a fascinating reflection on our past as well as a source of inspiration for a new century of students and professionals in criminal justice, corrections, social history, and law enforcement.

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.