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July 17, 1991

Decision Analysis: Society and Individuals

Author Affiliations

University of Kentucky Chandler Medical Center Lexington

University of Kentucky Chandler Medical Center Lexington

JAMA. 1991;266(3):363-364. doi:10.1001/jama.1991.03470030063023

To the Editor.  —In assuming that "society is nothing more than a collection of individuals,"1 Eddy has misconstrued the conflict between individuals and society regarding new medical treatment modalities. Individual people live in societies because societies can provide services to them that they cannot provide for themselves. These services range from national defense to public sanitation. In order to provide these services, society has needs that are distinct from the needs of its individual members. Thus, society may need such things as MX missiles and sewage treatment plants, for which an individual would have little use. Medical care, of course, is one of the more important services that a society provides to its members.Eddy gets to the heart of the matter when he states, "there are no controlled clinical trials showing any benefit of high-dose chemotherapy with autologous bone marrow transplantation (HDC-ABMT)." He then goes on to assume