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Ezekiel J. Emanuel, MD, PhD

JAMA. 2007;297:2131-2133.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

"There are 400,000 words in the English language, and there are seven of them that you can't say on television."¹ said George Carlin. For many years, health care faced the same inhibition; certain words could not be uttered in public about health care. Rationing was one such word. In the 1980s and 1990s, commentators who discussed rationing, such as Callahan and Lamm, were publicly censured for their views.^2-3

The words that are used and the words that cannot be used in public reveal a tremendous amount about how people think and act, about what is assumed, and what we aspire to.⁴ Usual phrases express the conventional wisdom, what the public accepts reflexively, without explanation, justification, or challenge. Conversely, those words that cannot be said on TV reveal what many refuse to accept or believe. Words that should not be uttered in public—but still may be . . . [Full Text of this Article]

"Best Health Care System in the World"

Author Affiliation: Department of Clinical Bioethics, The Clinical Center, National Institutes of Health, Bethesda, Md.

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