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First, Do No Harm
What is life worth? And what is a life worth living?
At a time when America faces vital choices about the future of its health care, former New York Times correspondent Lisa Belkin takes a powerful and poignant look at the inner workings of Hermann Hospital in Houston, Texas, telling the remarkable, real-life stories of the doctors, patients, families, and hospital administrators who must ask--and ultimately answer--the most profound and heart-rendng questions about life and death.
At a time when America faces vital choices about the future of its health care, former New York Times correspondent Lisa Belkin takes a powerful and poignant look at the inner workings of Hermann Hospital in Houston, Texas, telling the remarkable, real-life stories of the doctors, patients, families, and hospital administrators who must ask--and ultimately answer--the most profound and heart-rendng questions about life and death.
353 pages, Paperback
First published January 1, 1993
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1115 people want to read
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Displaying 1 - 30 of 95 reviews
November 2, 2021
Amazing
I barely know what to say. This book is wonderful and very sad at times. At one point I was in tears. If a book can bring that kind of emotion out of me then it’s a 5 star read. The care of patients is not alway black and white. Follow an in-depth look at several patients. Ask yourself how you would feel if you had to make life or death decisions.
I barely know what to say. This book is wonderful and very sad at times. At one point I was in tears. If a book can bring that kind of emotion out of me then it’s a 5 star read. The care of patients is not alway black and white. Follow an in-depth look at several patients. Ask yourself how you would feel if you had to make life or death decisions.
August 22, 2007
If you're interested in medical ethics, this book is amazing. The author recounts true case studies of several patients that in some way, shape or form require review of the hospital's ethical committee. It really forces you to reconcile your personal ethical beliefs with humane medical practices and brings to light the challenges that patients' families and health care practitioners face on a daily basis. A philosophically gritty yet inspiring read.
March 9, 2021
Въпросите, с които се занимава медицинската етика, винаги са трудни.
Съвременната медицина разполага с огромни възможности за поддържане на човешкия живот при травми, увреждания и заболявания, които само преди 50 години са били неминуемо фатални. Но интензивното лечение носи със себе си етични дилеми, за които малко лекари са подготвени. Обикновено сложните решения се вземат (поне в развитите страни) от комисии по етика.
Книгата ни въвлича в няколко истински случая от практиката на голяма болница в Хюстън, Тексас. Какво трябва да направят лекарите и администраторите с парализиран след престрелка пациент, който не може да диша самостоятелно? Освен това той е и здравно неосигурен, като няма да бъде приет в друга болница. Изключването му от апарата е равностойно на убийство, но в същото време лечебното заведение губи десетки хиляди долари всяка седмица по грижите за него.
А какво решение бихте взели за преждевременно родено бебе с тежка форма на спина бифида, която би го приковала на легло за цял живот, без възможност за контрол на пикочния мехур и червата? Ще се съгласите ли на палиативна операция, която би удължила живота, но при посочените условия? Как бихте обяснили избора на родителите, които със сигурност не разбират отговорностите, които ги чакат в бъдеще? Решението трябва да се вземе бързо. И какво ще направите, ако родителите откажат операцията? Ще стигнете ли до съд за отнемане на правата им върху детето?
Отговорите със сигурност не са лесни. Лекарите често не са подготвени за етичните дилеми, които изникват в ежедневната им практика. Все по-често в бъдеще ще се налага вземането на трудни решения. Време е да се замислим каква цена бихме платили за спасяването на живот.
Съвременната медицина разполага с огромни възможности за поддържане на човешкия живот при травми, увреждания и заболявания, които само преди 50 години са били неминуемо фатални. Но интензивното лечение носи със себе си етични дилеми, за които малко лекари са подготвени. Обикновено сложните решения се вземат (поне в развитите страни) от комисии по етика.
Книгата ни въвлича в няколко истински случая от практиката на голяма болница в Хюстън, Тексас. Какво трябва да направят лекарите и администраторите с парализиран след престрелка пациент, който не може да диша самостоятелно? Освен това той е и здравно неосигурен, като няма да бъде приет в друга болница. Изключването му от апарата е равностойно на убийство, но в същото време лечебното заведение губи десетки хиляди долари всяка седмица по грижите за него.
А какво решение бихте взели за преждевременно родено бебе с тежка форма на спина бифида, която би го приковала на легло за цял живот, без възможност за контрол на пикочния мехур и червата? Ще се съгласите ли на палиативна операция, която би удължила живота, но при посочените условия? Как бихте обяснили избора на родителите, които със сигурност не разбират отговорностите, които ги чакат в бъдеще? Решението трябва да се вземе бързо. И какво ще направите, ако родителите откажат операцията? Ще стигнете ли до съд за отнемане на правата им върху детето?
Отговорите със сигурност не са лесни. Лекарите често не са подготвени за етичните дилеми, които изникват в ежедневната им практика. Все по-често в бъдеще ще се налага вземането на трудни решения. Време е да се замислим каква цена бихме платили за спасяването на живот.
April 10, 2009
A compelling look at the tough decisions doctor's, parents and others are forced to make each day in an Intensive Care Unit. The book was very well written, although I was a tad aghast at some of the feelings and expressions of a few doctor's who view human life as "well, let 'em die and we'll move on" because the patient didn't have enough money or insurance to support their care!!
From the back cover:
"A young doctor must decide whether last ditch surgery will prolong a fifteen year old's life or simply prolong his agony. A poor, uninsured immigrant, paralyzed by a bullet in his spine, is explicitly offered the choice to die. A mother and father fight to take their fragile, premature twins off the machines that keep them alive. What is life worth? And what is a life worth living? At a time when America faces vital choices about the future of its health care, former New York Times correspondent Lisa Belkin takes a powerful and poignant look at the inner workings of Hermann Hospital in Houston, Texas, telling the remarkable, real life stories of the doctors, patients, families and hospital administrators who must ask - and ultimately answer the most profound and heart-rending questions about life and death."
From the back cover:
"A young doctor must decide whether last ditch surgery will prolong a fifteen year old's life or simply prolong his agony. A poor, uninsured immigrant, paralyzed by a bullet in his spine, is explicitly offered the choice to die. A mother and father fight to take their fragile, premature twins off the machines that keep them alive. What is life worth? And what is a life worth living? At a time when America faces vital choices about the future of its health care, former New York Times correspondent Lisa Belkin takes a powerful and poignant look at the inner workings of Hermann Hospital in Houston, Texas, telling the remarkable, real life stories of the doctors, patients, families and hospital administrators who must ask - and ultimately answer the most profound and heart-rending questions about life and death."
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July 27, 2022Review to come.
November 14, 2008
It's dated, but still engrossing reading and well written. It is nonjudgemental towards the doctors, institutions, patients or parents. The book gives a real feel for the heartache, and ethical and moral considerations, that go into treating children and adults with terminal or incurable illness. Very few books are written about how difficult it is to make decisions, or be involved in the decision making process, that can directly lead to death. This book was worth reading.
November 29, 2021
Ooof. This was a heart wrenching read. It was written in the mid-90’s and it’s shocking how little has changed. Shady hospital administrators, vacillating ethics committees and the poor patients/families caught in the middle while trying to make the best possible decisions. I cried, cussed and got mad. As a nurse, I see these scenarios play out and it never gets easier. I recommend it, but gird your heart.
October 15, 2019
Dated, but unmatched in painting a clear picture of the challenges of healthcare ethics. Belkin’s review of the history of the Hermann Health System (now Memorial Hermann Health System) and clear imparting of emotion on behalf of these patients is insightful and powerful.
October 2, 2023
If I could give this book ten stars, I would.
This work of nonfiction, which reads like a gripping novel, covers six months in Houston’s Hermann Medical Center.
Hugely entertaining and informative, it relates the events of this time through specific case studies, meetings of the Hospital Ethics Committee, and the cost of providing medical care to uninsured and at-need patients.
The first patient we meet is Patrick. Born with a digestive tract disorder, the 15-year-old has spent most of his life in the hospital. A lifetime hooked to machines and feeding tubes has left his body unable to perform functions that should occur naturally. His story, told throughout the book, is a continued debate of whether to continue life support or allow him to die.
Armando, a 25-year-old gunshot victim, comes to the hospital with a C-1 spinal cord injury, paralyzed from the nose down. His doctors sadly realize Armando is forever to be a “head in a bed,” incapable of any independent movement for all his remaining days.
Newborn baby girl Taylor is the third case, born severely premature with a birth weight of barely a pound. Sustained by lifesaving measures and scores of family and medical professionals, every organ in her palm-sized body fights for survival.
In the height of Taylor’s struggle her mother asks, “Would God want her to live this way?”
Essentially, this question drives the meetings of the Hospital Ethics Committee (on moral and legal, rather than religious grounds). Even if staff CAN keep a patient alive, SHOULD they? Conversely, although a patient or their parents may opt for death, when is it right to cease lifesaving efforts?
This question weighs every day at Hermann Medical Center.
Founded by the estate of oil and land tycoon George Henry Hermann following his 1914 death, the history of the hospital tracks neatly with advances in modern medicine. Prior to that, hospitals served mostly as warehouses for the sick and dying, and most surgeries were mere amputations. The introduction of antibiotics and surgical strides made hospitals places of healing.
As medical possibilities grew, so did expenses. This particularly concerned centers such as Hermann, originally designated to provide free care to the “indigent, sick and infirm.” A lofty goal, but daunting in a modern era when hospital stays for lifelong patients such as Patrick could run into the millions of dollars.
The stories of these patients and this hospital make FIRST, DO NO HARM a compelling read. Barely able to put this book down, I finished it in three days with a great appreciation for modern medicine and the dedicated souls in its practice.
This work of nonfiction, which reads like a gripping novel, covers six months in Houston’s Hermann Medical Center.
Hugely entertaining and informative, it relates the events of this time through specific case studies, meetings of the Hospital Ethics Committee, and the cost of providing medical care to uninsured and at-need patients.
The first patient we meet is Patrick. Born with a digestive tract disorder, the 15-year-old has spent most of his life in the hospital. A lifetime hooked to machines and feeding tubes has left his body unable to perform functions that should occur naturally. His story, told throughout the book, is a continued debate of whether to continue life support or allow him to die.
Armando, a 25-year-old gunshot victim, comes to the hospital with a C-1 spinal cord injury, paralyzed from the nose down. His doctors sadly realize Armando is forever to be a “head in a bed,” incapable of any independent movement for all his remaining days.
Newborn baby girl Taylor is the third case, born severely premature with a birth weight of barely a pound. Sustained by lifesaving measures and scores of family and medical professionals, every organ in her palm-sized body fights for survival.
In the height of Taylor’s struggle her mother asks, “Would God want her to live this way?”
Essentially, this question drives the meetings of the Hospital Ethics Committee (on moral and legal, rather than religious grounds). Even if staff CAN keep a patient alive, SHOULD they? Conversely, although a patient or their parents may opt for death, when is it right to cease lifesaving efforts?
This question weighs every day at Hermann Medical Center.
Founded by the estate of oil and land tycoon George Henry Hermann following his 1914 death, the history of the hospital tracks neatly with advances in modern medicine. Prior to that, hospitals served mostly as warehouses for the sick and dying, and most surgeries were mere amputations. The introduction of antibiotics and surgical strides made hospitals places of healing.
As medical possibilities grew, so did expenses. This particularly concerned centers such as Hermann, originally designated to provide free care to the “indigent, sick and infirm.” A lofty goal, but daunting in a modern era when hospital stays for lifelong patients such as Patrick could run into the millions of dollars.
The stories of these patients and this hospital make FIRST, DO NO HARM a compelling read. Barely able to put this book down, I finished it in three days with a great appreciation for modern medicine and the dedicated souls in its practice.
July 24, 2011
First, Do No Harm is an essential book for each and every person present on earth although, it wouldn't be that way. It is a book addressing the many complexities of being a doctor. The question it keeps on asking and which also taps into our conscience, is that whether medicine is ultimately aiming to do too much.
The book essentially deals with a big city hospital and addresses four different cases involving ethics as the chief topic of concern. Increasingly, medicine is becoming about economics and doctors about businessmen. Although, no one would like to think so hospitals as giving more importance to insurance and money rather than the patient and doctors to prefer patients on the basis of their financial status.
Though, the answer to 'What is life worth?" and what can be considered as a life worth saving or to just having to prolong death is different. Yet, the book has nothing to with religion and everything to do with how a particular case can be dealt with.
In all, it is a wonderful book which may brings tears to the eyes especially when considering that it is a non-fiction book. I salute Lisa Belkin for writing such a book and opening many doors to the unknown. I would highly recommend it.
The book essentially deals with a big city hospital and addresses four different cases involving ethics as the chief topic of concern. Increasingly, medicine is becoming about economics and doctors about businessmen. Although, no one would like to think so hospitals as giving more importance to insurance and money rather than the patient and doctors to prefer patients on the basis of their financial status.
Though, the answer to 'What is life worth?" and what can be considered as a life worth saving or to just having to prolong death is different. Yet, the book has nothing to with religion and everything to do with how a particular case can be dealt with.
In all, it is a wonderful book which may brings tears to the eyes especially when considering that it is a non-fiction book. I salute Lisa Belkin for writing such a book and opening many doors to the unknown. I would highly recommend it.
July 27, 2012
It was an eye opening read. The real life health situations that the people in the book experience are heartbreaking at times. For the parents that had to make that life/death decision for their children was heartbreaking. Health is not often a topic that crosses my mind, but this book made you think of the life/death decisions that hospitals all around the county make and unfortunatly money is often a factor. I appreciate how Belkin exposed the money part of healthcare. For me the root of the book surrounded money, patients and the best treatment was a factor because it made those decisions more human and easier to understand. It is a well worth read.
May 16, 2017
I'd like to say I loved this book but the subject matter was so draining to get through. It is so depressing and it makes me so angry. Angry that people are faced with such decisions in the first place. Angry that people would lose their friends because of what they are going through. You are wrong if you make one decision. You are wrong if you make the opposing decision. Too many ethical, moral, and legal implications. God forbid if you're a Christian as well and are faced with something like this. I couldn't even imagine the guilt.
The doctors are pressing a family to make a decision. The highly stressed family finally reaches a very difficult decision and then told by these same doctors that they are going to fight that decision. How messed up is that!
Without the advances in medical treatments, families would never be faced with such difficult decisions. And yet those same advances in medicine can and do work wonders for others.
Cases such as this are discussed at length: The life of a newborn preemie facing what could be a very difficult life is discussed over and over again. That child is highly deformed, will require several surgeries, will never lead a "normal” life. Who's to say whether that child should be left on a ventilator or removed from it? What is best for the child? What is best for the family? How much is it costing the insurance companies? How much is it costing the hospital? How much is it costing the family? And finally, how much is it costing the baby?
What is the answer when a perfectly "normal” unborn child doesn't get even a twinge of consideration.
I’d have to say 3 stars because it was terribly awful to get through and it was getting me angry and sad.
The doctors are pressing a family to make a decision. The highly stressed family finally reaches a very difficult decision and then told by these same doctors that they are going to fight that decision. How messed up is that!
Without the advances in medical treatments, families would never be faced with such difficult decisions. And yet those same advances in medicine can and do work wonders for others.
Cases such as this are discussed at length: The life of a newborn preemie facing what could be a very difficult life is discussed over and over again. That child is highly deformed, will require several surgeries, will never lead a "normal” life. Who's to say whether that child should be left on a ventilator or removed from it? What is best for the child? What is best for the family? How much is it costing the insurance companies? How much is it costing the hospital? How much is it costing the family? And finally, how much is it costing the baby?
What is the answer when a perfectly "normal” unborn child doesn't get even a twinge of consideration.
I’d have to say 3 stars because it was terribly awful to get through and it was getting me angry and sad.
February 5, 2023
I've been wanting to read this book for many years now but it has been difficult to accomplish this dream as it is really hard to find this book. Thanks to Scribd, I got my hands on this. It took me quite a while to finish it. This was partly due to being extremely busy with another project for a week; otherwise I would probably have finished this earlier. Still, this book didn't captivate me the way I thought it would. I have a hard time finding a reason for this. Previously, I haven't often taken to books written by journalists; maybe they aren't trained to keep you interested for more than a few pages? The style of the writing was very matter-of-fact and the storytelling reminded me of a freight train that moves on steadily with very few ups and downs. It would be nice to know in which role the writer attended the meetings of the committee? Was it just for the book or was there a role for her in the committee as well?
March 16, 2018
I read this book 15 minutes per day over the course of a school year. A book I picked up to pass the time while watching a certain area at work 15 minutes each day. I finally finished it and it was decent. It’s incredible to think about how even in the recent past ethics were not nearly as what they are today. As a society we have come a long way yet the question still remains “what is right?” That question will never change and this book shows why. I did find that while the main story ended completely, the others were abruptly ended in the epilogue. Better closure with a short chapter on each would have been nice instead of throwing them all together at the end like an afterthought.
February 28, 2023
I think everyone in healthcare should read this book. There are points in my daily work as an ICU nurse that you start to wonder, when is it too much? When are we doing more than they would have wanted? Are we not doing what they would have wanted?
This screams to understand autonomy and choices from the patient's perspective. As an older book, a lot of the language is outdated, but I think the point rains so truly important as we advance in healthcare. I will require this read of my future students when I progress more into education.
This screams to understand autonomy and choices from the patient's perspective. As an older book, a lot of the language is outdated, but I think the point rains so truly important as we advance in healthcare. I will require this read of my future students when I progress more into education.
January 7, 2024
A summer at Hermann Hospital in Houston. This non fiction book follows different patients and different doctors and everything that goes into providing care and, in most instances, deciding what care is appropriate.
I sobbed with Baby Taylor. Really, in all cases, it was impossible to get angry at any possible decision of care. So much thought goes into every case.
There was some back story provided about how the Hospital came to be. "Friendly Lawsuit" my ass. Just a way to get something that wasnt what was intended
Fabulous memoir
I sobbed with Baby Taylor. Really, in all cases, it was impossible to get angry at any possible decision of care. So much thought goes into every case.
There was some back story provided about how the Hospital came to be. "Friendly Lawsuit" my ass. Just a way to get something that wasnt what was intended
Fabulous memoir
June 24, 2024
Reads like any made-up story read except it is complete true stories. Medical ethics are such a complicated issue and honestly outside of a hospital it is not something that people talk about using real world examples to defend their ideas. I loved how this book brought to life many perspectives of different ethical medical decisions that were made by a variety of doctors, parents, nurses, and committees.
November 2, 2020
A very good look behind the scenes at the tough decisions some doctors, nurses, and administrators have to make about patients. Lisa Belkin did a wonderful job at presenting the information in a way that can be easily understood by non-medical people. I enjoyed the way she wrote the book to include many viewpoints about the same patient and treatment plans.
December 9, 2021
The author does a great job of not letting her personal feelings overshadow the events in this book. We have a chance to step back and see what is happening as it is. In this way it compels the reader to think on it's ethical questions personally; That's probably my favorite thing about this novel :)
March 11, 2023
This was a very interesting read for one of my classes. It is a close look into the many difficult decisions health care professionals make on a daily basis. As a non-native Houstonian, it was cool to learn more about Memorial Hermann and the med center as a whole. I learned so much more about hospital administration as well. Overall a very insightful read that can be impactful for anyone!
July 10, 2017
dramatic story of real doctors and patients making impossible choices at a big city hospital
see this and more than a hundred other organ donation/transplant related books - many with my personal reviews - at http://www.trioweb.org/resources/book...
see this and more than a hundred other organ donation/transplant related books - many with my personal reviews - at http://www.trioweb.org/resources/book...
January 2, 2022
This is essential for Houstonians in healthcare. A breathtaking account of several patients that all leave me moved. Lots of medical ethics involved, definitely a book that leaves you thinking long after you put it down each time.
June 21, 2024
This book was hard to put down. The emotions poured into this book and the peer into these lives made me realize how different each walk of life is on Earth. I smiled, cried, became angry, and grieved throughout reading this book.
January 15, 2025
It was a good read. It really got into the mind sets of different people's perspectives. I do say if you work in healthcare, you should take your time reading it because it can overwhelm you at times. (Especially if you go through similar events described in the book)
July 8, 2025
the book provided great insight on details you wouldn’t really think about when it comes to health care. there are so many rules and guidelines that are set for healthcare workers and details related to cost that i hadn’t known about prior to this book. overall interesting
November 23, 2017
Very well written about very tough situations.
March 30, 2019
I believe anyone that desires to be in a medical profession should read this book!
April 27, 2020
Thought-provoking. Excellent summer reading for students entering pre-med-type classes. Generates great class discussion topics!
September 1, 2020
A little outdated, but still informative. Would like to read an updated version of today's hospital workings.
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March 1, 2022Good book. A lot of detail
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