David J. Rothman is Bernard Schoenberg Professor of Social Medicine and History at the Columbia College of Physicians and Surgeons and president of the Institute on Medicine as a Professor.

Under Lock & Key: How Long?

Olivia de Havilland and Betsy Blair as inmates at a mental hospital in The Snake Pit, 1948
Although few people are satisfied with the quality of mental health services in the US, it is still startling to find physicians and psychiatrists enthusiastically calling for a return to asylums. One might think that the grim history of confinement would have precluded such advocacy. Whether in popular imagination (think …

The Organ Market

The body part that accounts for most sales of organs throughout the world is the kidney. As entire populations have become older, the number of patients with kidney disease that can lead to death has dramatically increased. Dialysis machines extend the lives of many of them. But some patients for …

The Shame of Medical Research

Until the 1990s American medical researchers performed most of their experiments on other Americans—frequently choosing subjects who were poor and vulnerable.[^1] Now, however, they are increasingly likely to conduct their investigations in third world countries on subjects who are even poorer and more vulnerable. Part of the reason is AIDS—the …

The International Organ Traffic

Over the past fifteen years, transplanting human organs has become a standard and remarkably successful medical procedure, giving new life to thousands of people with failing hearts, kidneys, livers, and lungs. But very few countries have sufficient organs to meet patients’ needs. In the United States, for example, some 50,000 …

What Doctors Don’t Tell Us

Except for Karen Ann Quinlan’s, no other patient’s death has transformed American medical practice so much as that of Libby Zion. Karen Ann Quinlan made history in the mid-1970s when the medical staff at St. Clare’s Hospital in New Jersey would not remove her from a respirator, as her parents …

The Crime of Punishment

The least controversial observation one can make about American criminal justice today is that it is remarkably ineffective, absurdly expensive, grossly inhumane, and riddled with discrimination. The beating of Rodney King was a reminder of the ruthlessness and racism that characterize many big city police departments. But the other aspects …

The New Romania

Immediately after the overthrow of the Ceauçescu regime in December 1989, European medical relief agencies discovered several hundred babies infected with AIDS in decrepit and filthy state orphanages throughout Romania. Images of the wasted bodies of infants, two and three to a crib, appeared on European and American television, arousing …

A Death in Zimbabwe

The death of one child from possible medical malpractice at a private hospital in Harare, the capital of Zimbabwe, might not seem a case of a human rights abuse on a continent where literally millions of people are dying from starvation and AIDS, and continue to suffer from such preventable …

Rationing Life

Must health care be rationed? Medical schools and research centers frequently hold conferences on such questions as “Is rationing inevitable?” and many new books address the question posed by the philosopher John Kilner in his book Who Lives? Who Dies? The inquiries are usually of three kinds. One addresses the …

India’s Awful Prisons

India has strong claims to being the world’s largest democracy. It has genuinely free elections and these have twice turned the once-dominant Congress party out of office. Its press is exceptionally outspoken and its judiciary, especially in the higher courts, is aggressively independent. Moreover, a variety of private and government …

How AIDS Came to Romania

Eight months after the cadaverous images of Romania’s babies with AIDS first shocked people throughout the world, almost every one of Romania’s orphanages and children’s hospitals provides a heartening example of the help being provided by European and American philanthropy. Yet at the same time, each of them continues to …