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Clinical Decision Making: From Theory to Practice
May 8, 1991

The Individual vs Society: Resolving the Conflict

Author Affiliations

Duke University Durham, NC

JAMA. 1991;265(18):2399-2406. doi:10.1001/jama.1991.03460180105044
Abstract

AN INDIVIDUAL can be in conflict with society whenever the individual uses a disproportionate amount of a health care service without paying for it.1 This either forces others to cover the cost of replacing the service or, if the cost is not repaid and the service is not replaced, deprives others of the benefits of the service. The first causes others financial harm. The second causes harm to their health. In either case, the "others" are what we call "society."

If the individual is incapable of paying, and if the service is considered essential,2 then the use of such a service is considered acceptable; it is viewed as part of society's obligation to individuals in need. However, as the individual's ability to pay increases, as the benefit provided by the service decreases, and as the cost of the service increases, the conflict grows.

The Source of the Conflict 

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