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September 2004

Should Physicians Prioritize Their Activities to Address Patients'Wants or Patients' Needs?

Arch Ophthalmol. 2004;122(9):1376-1378. doi:10.1001/archopht.122.9.1376

Toward the end of a recent conference, two ophthalmologists sketchedout their thoughts about possible future directions in the field of ophthalmology.One discussed a way to decrease the need for wearing glasses to improve visionand the other a method of bringing care to those who are presently underserved.These issues and others like them are not new to medical conferences. However,the different implications of the two presentations are, I believe, worthpondering.

We all make choices. Even if that assumption is wrong, and in fact weare completely preprogrammed, completely determined by environment, or weare a combination of "nature" and "nurture," it feels as if we make choices.Ethics is all about those choices we make (or seem to make).1-5 Someof the choices seem relatively trivial, such as whether to choose chocolateor vanilla ice cream for dessert, whereas others seem relatively momentous,such as voting yea or nay in Congress to a proposal to invade Iraq. If webelieve that the choices we make, especially when momentous, have any effect,then it would seem we should try to make those choices as appropriate, oreven better, as wise as possible.