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Is There a Conflict?

David M. Eddy, MD, PhD

JAMA. 1991;265(11):1446-1450.

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

Your Hospital Cafeteria: 7:40 AM

Dr Williams:

I need to fill you in on Mrs Smith.

Dr Hart:

Oh, yes, I remember her. Breast cancer, about 2 years ago. I saw her family in the hall yesterday. How is she?

W:

Unfortunately, she's gotten worse. She now has metastases to the liver and bone.

H:

Oh, dear, she's such a lovely woman. What's next?

W:

Well, I want to try high-dose chemotherapy with autologous bone marrow transplantation. I've told her about the 10% treatment mortality, about the high complication rates and side effects, and that there are no controlled trials showing benefit, but it's her only hope.

H:

Will her insurance company cover it?

W:

We're lucky there. Her employer is self-insured. They've agreed to cover the costs from an employee-funded health promotion fund. Apparently they don't want the bad publicity some of the other insurers have gotten when they've . . . [Full Text PDF of this Article]

Author Affiliations
Duke University Durham, NC

Footnotes
Reprint requests to Skyline Route, Box 32, Jackson, WY 83001 (Dr Eddy).

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