Paul Brodwin

As a medical anthropologist, I have spent 25 years studying the ethics of health care in their full cultural context. From rural Haiti to American inner cities, I listen to ordinary people speculating about the fundamental value questions inherent to medical treatment. Their way of framing ethical dilemmas illuminates larger debates about duties of care and the distribution of medical resources. My recent book "Everyday Ethics..." shows the experience of clinicians serving some of the most disenfranchised members of our society. How do they measure the rightness or wrongness of their work? What happens when they cannot live up to their own ideals? Their voices deserve to be heard alongside the usual bioethics experts from philosophy and the law. I hope this book raises the general awareness of public sector psychiatry. The defunding of state services as well as the stigma of mental illness worsen the suffering of people with severe symptoms. Reform must start with a clear appraisal of the current system and how providers negotiate the frustrations of their job.