David J. Rothman

Sheila M. Rothman

Service of the Engine is a common local Chichewa-English expression in the Malawian fishing village where the author did her fieldwork. It refers to the practice of taking various pills--known locally as Ciba--in order to prevent and cure diseases associated with sex. This study explores the sensitive interface between the use of pharmaceuticals, available through an extensive informal distribution system, and self-treatment of sex-related diseases. The author examines morally sensitive situations in which men and women opt for Ciba, and evaluates its efficacy, or effectiveness. The discussion not only covers physical and metaphorical aspects of efficacy, but also the possible social and moral effects of medication. It offers a fresh and empirically grounded perspective on the links between efficacy, sex-related diseases and moralities. Birgitte Bruun graduated from the Institute of Anthropology, University of Copenhagen, Denmark and is currently working with reproductive health projects for United Nations Population Fund (UNFPA) in Jakarta, Indonesia.

Bringing the Mentally Disabled Into the Community

The Willowbrook Wars

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

A History of How Law and Bioethics Transformed Medical Decision Making

Strangers at the Bedside

Norval Morris

Ranging from ancient times to the present, a survey of the evolution of the prison explores its relationship to the history of Western criminal law and offers a look at the social world of prisoners over the centuries

The Practice of Punishment in Western Society

The Oxford History of the Prison

A classic in American social history, first published in 1971, asks why Americans, beginning in the 1820s and 1830s simultaneously and confidently constructed prisons, insane asylums, reformatories, and almshouses to confine and treat their deviant and dependent population. In a new introduction, Rothman examines this core concern of European and American social history and analyzes the many answers that have been proposed. Annotation copyrighted by Book News, Inc., Portland, OR

Social Order and Disorder in the New Republic

The Discovery of the Asylum

The discovery of the asylum

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.

The Asylum and Its Alternatives in Progressive America

Conscience and Convenience

Steven Marcus

Stephanie A. Kiceluk

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.

Medicine and Western Civilization

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.

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.

Howard L. Rosenthal

What Do We Owe Each Other? includes essays by some of the finest social and political policy researchers in the United States. They address critical issues in contemporary American society. These range from the making of public opinion, the nature of the presumed social contract between government and its people, the special place of corporate governance and institutional investors with respect to social stability, the search for educational equality in a world of growing income disparities, the huge run up in prison populations and the decline of American citizenship, and not least, the ethical issues of selfless and selfish motivations with respect to organ transplants, and the sale of body parts. Although the volume is clearly focused on the United States of the past and present, it offers a long view of how social trends take on distinctive moral characteristics. The opening essay by Katherine Newman of Princeton University and Elisabeth Jacobs of Harvard University carefully documents how the political and social goals of the New Deal era outstripped the public opinion views of the time. They rise to a special level of analysis on how the policy processes can be uneven in one era and yet translate into a general good in later periods. Economic recovery and ideological dispositions were not in sync during the New Deal. As the contributors show, such disparities remain true of the American political process as a whole. The contributors display a wide diversity of opinion, but the volume is unified by the belief that ethical concerns play as large a role in defining American society as do economic interests. The book should attract the attention of political scientists, sociologists, economists, and above all, those people interested in how policy analysis is fused with moral considerations at the start as well as at the close of decision making as such. Howard L. Rosenthal is a professor of politics at New York University. He is the author of many journal articles and coauthor, with Alberto Alesina of Partisan Politics, Divided Government, and the Economy, and coauthor with Keith T. Poole of Ideology and Congress (available from Transaction).

David J. Rothman

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