Medicine’s Changing Means and Ends

This chapter shows how the press for new technologies in U.S. health care complicates the goals of medical practice in our aging society. It examines three types of treatment—the implantable cardiac defibrillator, kidney dialysis, and liver transplantation—to reveal how technological innovations and interventions become standard, necessary, logical, and rational. Analysis of those innovations shows which patients need them and what we come to want from them. Questions about how to measure successful treatment and what constitutes therapeutic benefit loom large here, and each patient’s story illustrates the quandary of determining how one should live in relation to the tools of medicine as one grows old.