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To the Editor. —
In his criticism of "the timid therapist" in "Primum Non Nocere" (238:589, 1977) Ray W. Gifford, Jr, MD, correctly identifies the problem of modern therapeutics as one of risk vs benefit. He betrays an unfortunate bias, however, in his contention that side effects are easy to enumerate, while "it is impossible to enumerate lives that have been saved or... suffering and discomfort that have been alleviated." Dr Gifford leaves the reader to infer that we cannot objectively weigh medical risks against rewards. Surely the enumeration of benefits is not only possible but also necessary for therapeutic progress. Surely it has always been more comforting for us to believe that our interventions are beneficial than to study the possibility that they are not.
Wilcox A. Benefit vs Risk. JAMA. 1978;239(5):401–402. doi:10.1001/jama.1978.03280320017004
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