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September 19, 1980

Truth in Mending

JAMA. 1980;244(12):1318-1319. doi:10.1001/jama.1980.03310120012007

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To the Editor.—  The article by Eben Alexander, Jr, MD (243:1241, 1980), "A 'Truth in Mending' Act," hits straight and true when he deplores cheating by patients and their attempt to involve their physicians to defraud insurance carriers, whether government or private. However, Dr Alexander's arguments, though on a high ethical plane, are not functional in today's world of consumeristic bending of the rules and "if its good for me it must be good" philosophy.His moralism is impeccable, except that it can trap us into inaction and impotence as Samuel Vaisrub, MD (243:1264, 1980), stressed in his editorial. Is the patient a malingerer or hysterical? Does he need treatment or police action? Are all self-serving symptoms suspect? These questions may be avoided by using the issue of enlightened self-interest. With this philosophy we do not cheat, simply because bending the rules diminishes us as physicians. Cheating the insurance company