Evidence Based Medicine and Societal Issues

Given finite resources, the medical system cannot provide every intervention no matter how small its potential benefit. From a societal perspective, it is therefore important for clinicians to judge interventions based on a balance between magnitude of benefit, quality of evidence, and resources. That is, one must keep in balance two questions: (1) Does it work? and (2) Should we do it? Otherwise, we could diminish the net health of the community by diverting resources from highly effective intervention to more marginally effective ones. The methods for such prioritization, however, are not yet well established. Cost-effectiveness analysis and cost-utility analysis are tools that can help, but many value judgments are necessary that go beyond quality of evidence. In the meantime, adhering to evidence-based principles of evaluating, for example, screening and diagnostic tools, may help eliminate ineffective redundancy and thus save costs while still achieving needed health outcomes.

A Disquistion On The Evils Of Using Tobacco

A Disquistion On The Evils Of Using Tobacco

Among the evils which a vitiated appetite has fastened upon mankind, those that arise from the use of Tobacco hold a prominent place, and call loudly for reform. We pity the poor Chinese, who stupifies body and mind with opium, and the wretched Hindoo, who is under a similar slavery to his favorite plant, the Betel but we present the humiliating spectacle of an enlightened and christian nation, wasting annually more than twenty-five millions of dollars, and destroying the health and the lives of thousands, by a practice not at all less degrading than that of the Chinese or Hindoo.

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