Functional Vertebrate Morphology

past the age of childbearing. Apparently, it is also a practice among some doctors to propose removal of a normal breast in women who must have the other removed because of cancer. Again, there is little evidence to support or refute the value of this operation. Even well-patient care is opened to scrutiny. The widespread use of screening tests such as the Pap smear, X-rays, tonometry, and breast self-examination is questioned. Again, Robin uses a cost-benefit approach and points out the harm that false positive results may cause, in terms of follow-up testing, financial cost, and emotional trauma. In comparison, he mentions examples of unquestionably useful tests such as screening for PKU and hypothyroidism in infants and discusses the importance of regular pediatric care and vaccination programs. He also points out that the growing number of such tests may lead to a preoccupation with illness that may itself be detrimental to the quality of life. Other chapters in the book are equally challenging and provocative. They cover such topics as the care of the critically ill and the use of ICUs, the care of elderly patients, the dangers of medicine as a business, and the risks and benefits of regarding the doctor as God. Robin also takes the time to point out the good that medicine does and can do and to affirm his belief that, on the whole, doctors are highly capable, intelligent, and caring professionals. The appendix of the book outlines his recommendations for changing the medical system, which include changes in the training of medical students, improved clinical trials, performance of only relevant diagnostic procedures, and so on. In summary, this book is interesting and provocative. It should interest health care professionals who are not afraid to hear some strong and convincing criticisms of the current medical system, as well as their patients.