Acknowledgments ix
Introduction. Diagnosing Twenty-First-Century Health Care 1
Part I: The Quandry and Unexamined Ordinariness of Twenty-First-Century Medicine
1. Ordinary Medicine in Our Aging Society: The Dilemma of Longevity 21
Part II. The Chain of Health Care Drivers
2. The Medical-Industrial Complex I: Evidence-Based Medicine, the Biomedical Economy, and the Ascendance of Clinical Trials 53
3. The Medical-Industrial Complex II: Access, Industry, and the Clincial Trials Phenomenon 79
4. "Reimbursement Is Critical for Everything": Medicare and the Ethics of Managing Life 99
Part III: Medicine's Changing Means and Ends
5. Standard and Necessary Treatments: The Changing Means and Ends of Technology 127
6. Family Matters: Kidneys and New Forms of Care 165
7. Influencing the Character of the Future: Prognosis, Risk, and Time Left 195
8. For Whose Benefit? Our Shared Quandary 217
Conclusion. Toward a New Social Contract? 238
Notes on the Research 249
Notes 255
Bibliography 285
Index 307