Oxford University Press's
Academic Insights for the Thinking World


Medicare and end-of-life medical care

Medicare recently announced that it will pay for end-of-life counseling as a legitimate medical service. This announcement provoked little controversy. Several groups, including the National Right to Life Committee, expressed concern that such counseling could coerce elderly individuals to terminate medical treatment they want. However, Medicare’s statement was largely treated as uncontroversial—indeed, almost routine in nature.

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Toilet paradigms and the sanitation crisis in India

Sanitation has evinced considerable interest from policy-makers, lawmakers, researchers and even politicians in recent years. Its transformation from a social taboo into a topic of general conversation is evident from the fact that one of the central themes of a recent mainstream Bollywood production (Piku, 2015) was the inability of the protagonist’s father to relieve himself.

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Medicare and Medicaid myths: setting the 50-year record straight

Over the past half-century, Medicare and Medicaid have constituted the bedrock of American healthcare, together providing insurance coverage for more than 100 million people. Yet these programs remain controversial: clashes endure between opponents who criticize costly, “big government” programs and supporters who see such programs as essential to the nation’s commitment to protect the vulnerable.

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Cancer diagnosis response: Being hit by an existential Mack Truck

When I meet with patients newly diagnosed with cancer, they often find it difficult articulate the forbidding experience of being told for the first time they have cancer. All they hear is ‘die’-gnosis and immediately become overwhelmed by that dreadful feeling: “Oh my God, I’m gonna die!” I often try to meet them in that intimate and vulnerable moment of existential shock and disbelief by stating, “It’s like being hit by an existential Mack truck.”

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First biosimilar drug approved for sale in the United States

New options for biologic cancer treatment are coming for the first time to the United States, and their arrival could help drive down costs for some of the biggest-ticket items in cancer care. Treatments that interfere with cancer’s biological underpinnings have revolutionized treatment for some cancers. But their cost now accounts for half of oncology drug spending—up from 11% a decade ago, according to the IMS Institute for Healthcare Informatics.

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A treatment for despair and loss of meaning

The Psychotherapy Laboratory within the Department of Psychiatry and Behavioral Sciences at MSKCC was established about 12 years ago. I have been the Director of the Lab from its establishment. In addition to developing interventions for anxiety, depression, and PTSD, we have studied a whole group of existential problems that had as yet no established interventions.

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Soloman_Making Medical Knowledge

On ‘cookbook medicine,’ cookbooks, and gender

It is not a compliment to say that a physician is practicing “cookbook medicine.” Rather, it suggests that the physician is employing a “one size fits all” approach, applying unreflective, impersonal clinical methods that may cause patient suffering due to lack of nuanced, reflective, and humanistic care. The best physicians—just like the best cooks—make use of creativity, intuition, judgment, and even je ne sais quoi.

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The belated autopsy of a forgotten Revolutionary War hero

John Paul Jones died in Paris on this day in 1792, lonely and forgotten by the country he helped bring into existence. Shortly before his death, he began to lose his appetite. Then his legs began to swell, and then his abdomen, making it difficult for him to button his waistcoat and to breath.

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Oxford Medicine Online

War: a legacy of innovation and trauma

War. Of all human endeavours, perhaps none demonstrates the extremes of ingenuity and barbarity of which humanity is capable. The 21st century may be the century in which the threat of perpetual war is realised. Although many innovations have been brought about as a bi-product of the challenges war presents, the psychological and physical trauma wrought on the human body may prove too high a cost.

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What stays when everything goes

Imagine the unimaginable. Suffering from Alzheimer’s Disease (AD), the person with whom you shared most of your life has forgotten who you are, and even worse, can no longer remember their own experiences, their relationships, and how to behave appropriately in everyday situations. But although most of their long-term memory is heavily impaired, they may continue to relate astonishingly well to autobiographically relevant pieces of music.

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Jonas Salk Book

Who was Jonas Salk?

Most revered for his work on the polio vaccine, Jonas Salk was praised by the mainstream media but still struggled to earn the respect and adoration of the medical community. Accused of abusing the spotlight and giving little credit to fellow researchers, he arguably become more of an outcast than a “knight in a white coat.” Even so, Salk continued to make strides in the medical community, ultimately leaving behind a legacy larger than the criticism that had always threatened to overshadow his career.

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Overcoming the “angel” perception of nursing

Most of us have vaguely positive sentiments about nurses, but at the same time, nursing is plagued by feminine stereotypes that continue to undermine the profession. These double-edged views are never more striking than in efforts to honor nurses, which often rely on emotional “angel” images rather than recognition of nurses’ health skills or tangible contributions to patient outcomes.

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Hearing, but not understanding

Imagine that your hearing sensitivity for pure tones is exquisite: not affected by the kind of damage that occurs through frequent exposure to loud music or other noises. Now imagine that, despite this, you have great problems in understanding speech, even in a quiet environment. This is what occurs if you have a temporal processing disorder

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Immune profiling of tumors may better stage early cancers

When immune cells infiltrate tumors in large numbers, patients do better. Now researchers aim to harness this immune response to predict outcomes. The Society for Immunotherapy of Cancer (SITC) in Milwaukee is coordinating an international effort to validate Immunoscore, an assay that quantifies this immune response.

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African health leaders claiming the future

Health leaders in sub Saharan African countries face some of the most demanding challenges anywhere in the world. Disease, poverty, the legacy of colonialism and, all too often, conflict, corruption and political instability, combine to make improving health extraordinarily difficult. Looking back we can see many great African health leaders who have played their part as the following few examples show.

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Can schizophrenia really be treated by “talk therapy” alone?

A recent study published by psychologist Anthony Morrison and colleagues in the British medical journal, The Lancet, is stirring up a long-standing debate about the treatment of schizophrenia. The article describes a randomized controlled trial with people diagnosed with schizophrenia who refused to take psychiatric medications called “antipsychotics.” The researchers tested whether these patients could be treated with a form of talk therapy called cognitive-behavioral therapy (CBT) in lieu of medications.

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