Strong Medicine

In one form or another, health care is now being rationed; not every patient receives all that is possibly beneficial for him - sometimes with tragic consequences. Decisions to ration raise a classic dilemma: how can we treat an individual with dignity and genuine respect when he is being short-changed by an efficient policy that seems best overall? Strong Medicine argues that we can respect the individual, if those policies represent the hard trade-off preferences of patients controlling resources for their larger lives. Rationing is still strong medicine to swallow, but then it becomes what patients, as well as the doctor, ordered. Menzel develops this central idea and applies it to major issues of health policy and economics: the notion of pricing life, the long-run cost of prevention, measuring quality of life, imperilled newborns, adequate care for the poor, containing costs by market competition, malpractice suits, procuring organs for transplant, and dying expensively in old age. He provides a hard-hitting, critical philosophical discussion of these issues, in non-technical language accessible to a wide range of readers.