Risky medicine : our quest to cure fear and uncertainty

Will ever-more sensitive screening tests for cancer lead to longer, better lives? Will anticipating and trying to prevent the future complications of chronic disease lead to better health? Not always, says Robert Aronowitz in __Risky Medicine.__ In fact, it often is hurting us. Exploring the transformation of health care over the last several decades that has led doctors to become more attentive to treating risk than treating symptoms or curing disease, Aronowitz shows how many aspects of the health system and clinical practice are now aimed at risk reduction and risk control. He argues that this transformation has been driven in part by the pharmaceutical industry, which benefits by promoting its products to the larger percentage of the population at risk for a particular illness, rather than the smaller percentage who are actually affected by it. Meanwhile, for those suffering from chronic illness, the experience of risk and disease has been conflated by medical practitioners who focus on anticipatory treatment as much if not more than on relieving suffering caused by disease. Drawing on such controversial examples as HPV vaccines, cancer screening programs, and the cancer survivorship movement, Aronowitz argues that patients and their doctors have come to believe, perilously, that far too many medical interventions are worthwhile because they promise to control our fears and reduce uncertainty. __Risky Medicine__ is a timely call for a skeptical response to medicine’s obsession with risk, as well as for higher standards of evidence for risk-reducing interventions and a rebalancing of health care to restore an emphasis on the actual curing of and caring for people suffering from disease. "Will ever-more sensitive screening tests for cancer lead to longer, better lives? Will anticipating and trying to prevent the future complications of chronic disease lead to better health? Not always, says Robert Aronowitz in Risky Medicine. In fact, it often is hurting us. Exploring the transformation of health care over the last several decades that has led doctors to become more attentive to treating risk than treating symptoms or curing disease, Aronowitz shows how many aspects of the health system and clinical practice are now aimed at risk reduction and risk control. He argues that this transformation has been driven in part by the pharmaceutical industry, which benefits by promoting its products to the larger percentage of the population at risk for a particular illness, rather than the smaller percentage who are actually affected by it. Meanwhile, for those suffering from chronic illness, the experience of risk and disease has been conflated by medical practitioners who focus on anticipatory treatment as much if not more than on relieving suffering caused by disease. Drawing on such controversial examples as HPV vaccines, cancer screening programs, and the cancer survivorship movement, Aronowitz argues that patients and their doctors have come to believe, perilously, that far too many medical interventions are worthwhile because they promise to control our fears and reduce uncertainty. Risky Medicine is a timely call for a skeptical response to medicine's obsession with risk, as well as for higher standards of evidence for risk-reducing interventions and a rebalancing of health care to restore an emphasis on the actual curing of and caring for people suffering from disease"--Provided by publisher In medicine today, public health and medical interventions are largely risk reducing and risk controlling rather than treating symptoms or curing disease. In several cases risk factors have almost become diseases in themselves. As Robert Aronowitz vividly depicts, we are experiencing a convergence of risk and disease, and a market-driven expansion of risk interventions. We increasingly understand and accept that many medical interventions are efficacious because they reduce risk. It is often the case, however, that little science supports risk interventions that have become commonplace. Risky Medicine wrestles with the problems associated with the conflation of risk and traditional notions of disease. It explores not only how we got to this point but what the implications are for our health care system and our personal dealings with doctors. The subject is hugely important for patients and doctors, and it matters enormously in health care policy going forward. Contents......Page 6 I......Page 8 1. Risky medicine: Our quest to cure fear and uncertainty......Page 10 2. The converged experience of risk and disease......Page 28 3. The social and psychological efficacy of risk interventions......Page 52 II......Page 74 4. The Framingham Heart Study: The emergence of the risk factor approach......Page 76 5. Gardasil: A vaccine against cancer and a drug to reduce risk......Page 102 6. Lyme disease vaccines: A cautionary tale for risk intervention......Page 118 7. Cancer survivorship: The entangled experience of risk and disease......Page 144 8. The global circulation of risk interventions......Page 164 III......Page 188 9. Situating health risks: An opportunity for disease prevention policy......Page 190 10. Epilogue: The risk system......Page 208 Acknowledgments......Page 230 Notes......Page 234 Index......Page 274 Risky medicine : our quest to cure fear and uncertainty The converged experience of risk and disease The social and psychological efficacy of risk interventions The Framingham heart study and the emergence of the risk factor approach to coronary heart disease : 1947-1970 Gardasil : a vaccine against cancer and a drug to reduce risk The rise and fall of the lyme disease vaccines : a cautionary tale for risk interventions in American medicine and public health Cancer survivorship : the entangled experience of risk and disease The global circulation of risk interventions Situating health risks : an opportunity for disease prevention policy Epilogue : the risk system. "Will ever-more sensitive screening tests for cancer lead to longer, better lives? Will anticipating and trying to prevent the future complications of chronic disease lead to better health? Not always, says Robert Aronowitz. In fact, it often is hurting us... Drawing on such controversial examples as HPV vaccines, cancer screening programs, and the cancer survivorship movement, Aronowitz demonstrates that patients and their doctors have come to believe, perilously, that far too many medical interventions are worthwhile because they promise to control our fears and reduce uncertainty." -- Taken from book flyleaf