Abstract

KIE: Eddy argues that many medical interventions that make sense from the point of view of the individual patient and his or her physician might not make sense from the point of view of society -- either because they restrict resources available for other needs, or because they drive up the cost of resources. He illustrates his argument with the case of a hypothetical patient with metastatic breast cancer whose physician offers her an expensive investigative treatment that is 5% effective. The cost of the treatment would buy 10 years of mammogram screening for 150 women. Eddy discusses the nature of the conflict between individuals and society when making judgments regarding the value of different health care activities. He will discuss the resolution of the conflict in a future JAMA article.