The Nature of Clinical Medicine: The Return of the Clinician

ISBN : 9780199974863

Eric J. Cassell
352 ページ
163 x 236 mm

Clinical medicine, as a thinking discipline, is concerned not only with what clinicians do, but why. When physicians act in medicine they have some purpose or goal in mind. What they actually do and how they go about it is in the service of their purposes and their goals. Such goals cover a wide range of topics centering on patients, the doctor-patient relationship, the acts of doctoring patients, and the goals involved in being a physician among other physicians working within the institutions of medicine. The Nature of Clinical Medicine takes its direction from a catalog of goals of medicine that range from the expected diagnosis and treatment of diseases to wider concerns for patients, for physicians, and for medicine itself. The chapters are specific in teaching the kinds of knowledge that clinicians require in order to be able to achieve these goals. The central focus of the clinician and of this book is the patient. According to Eric Cassell, everything else, including the disease, is secondary. Using many examples from real-life medical practice, each chapter examines the different kinds of thought involved in caring for the patient. Cassell takes on a variety of difficult issues, from thinking about values to developing wisdom. The care of the dying, what thinking itself is, and finally, why would one want to do this exciting and rewarding but difficult work, come under discussion in this book.


Chapter 1. The Goals of Medicine
Chapter 2. A Story about a Patient with Aortic Stenosis
Chapter 3. What are Facts in Medicine?
Chapter 4. Clarify the Chain of Events that Led to the Present State: The Case as a Narrative
Chapter 5. The Case of Myra Manner
Chapter 6. Examine Your Presuppositions and Preconceptions
Chapter 7. Separate and Examine the Values at Issue
Chapter 8. A Question of Judgment
Chapter 9. The Patient, the Doctor, And the Relationship
Chapter 10. Observation, Prognosis, and Prognosticating
Chapter 11. Thinking in Medicine
Chapter 12. Accepting the Challenge


Eric J. Cassell is an attending physician at New York Presbyterian Hospital, as well as Emeritus Professor of Public Health at Weill Cornell Medical College and Adjunct Professor of Medicine at McGill University. He retired from the active practice of internal medicine in 1998 after thirty-seven years. Cassell is the author of The Healer's Art, The Place of the Humanities in Medicine, Changing Values in Medicine, two volumes on doctor-patient communication entitled Talking with Patients and Doctoring: The Nature of Primary Care Medicine, and The Nature of Suffering and the Goals of Medicine, now in its second edition. Cassell is a Fellow of the Hastings Center, Member of the Institute of Medicine of the National Academy of Sciences, and Master of the American College of Physician.