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November 10, 1951


JAMA. 1951;147(11):1054-1055. doi:10.1001/jama.1951.03670280056016

In discussing medical care for the needy, Darley1 states both that health involves the assumption of individual responsibility and that the upsurge of social consciousness places a premium on human values and resources. The partial anthithesis of these two statements poses a dilemma for medical effectiveness in present day society. Personal independence and social welfare are two basic expectations that democracy encourages. A high premium is placed on the adequacy of the individual, and the need for adequate care for every person is emphasized. However, being cared for and taking care of oneself involve conflicting psychological meanings. How different are the health problems that are involved in accepting care and maintaining independence?

The term paternalism shows this conflict. The physician easily becomes a person toward whom dependency attitudes generated in childhood may be directed. Persons who have attained maturity may lose their feeling of independence because of illness and