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March 24/31, 1999

Marginal Medicine

Author Affiliations

Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999

JAMA. 1999;281(12):1082-1083. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-12-jbk0324

To the Editor: Mr Lamm's1 excellent essay should be required reading for all physicians, politicians, and especially citizens of any society in which competition exists for monetary resources.

Society makes value judgments on a daily basis, weighing the cost to the entire society vs the possible benefit to the individual for each decision he or she makes. For example, lighting a mile of highway costs money, both for the installation as well as the ongoing cost of maintenance and electricity. Were the cost involved $1 per mile, it is safe to assume that all roads would be lit. The actual cost is well in excess of $1 million per mile so society has chosen to light some roads but not others. An unlit roadway can produce serious health consequences, yet we do not hear that all roads should have equal access to highway lights.

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