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Robert L. Wears, MD
University of Florida Jacksonville

JAMA. 1995;273(13):995-996.

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

To the Editor.

—The description by Dr Eddy¹ of how we might "help patients understand the consequences of a limited resource pool and the need to be fair" conflicts with the idea of informed consent and full patient participation in decision making. This conflict needs to be addressed explicitly if we are to make any headway in reducing the rate of increase in costs. Eddy suggests that as physicians guide patients toward accepting collectively better but individually worse options that "in most cases there will be no need to say anything at all. In other cases the explanation might be, 'Well, for patients like you the appropriate approach is....'" While many (including me) agree with Eddy's position that it is not unethical to weigh economic costs against health benefit,² his recommendation that physicians should simply fail to mention the existence of a therapeutic alternative (offering greater benefit but . . . [Full Text PDF of this Article]

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