The Disease-Reservoir Hypothesis

  • Robert M. Kaplan

Chapter 1 began with the story of Sally, a 77-year-old woman who had been diagnosed with ductal breast cancer. Sally received aggressive treatment and went on to live a life free of breast cancer. She also suffered from the consequences of the treatment. Not everyone believes that Sally required treatment, but few would advise her against taking action. The suggestion that Sally consider foregoing treatment disturbs many people. However, we do need to ask, what would happen if she consumed, and if we as a nation consumed, less medical care? The question is deceptively simple, but the answer maddeningly difficult.

To attempt an answer, it is best to begin at the beginning. The purpose of healthcare is to improve health. Health outcomes can be defined in terms of only two measurements: quantity of life and quality of life. A successful treatment is one that makes people live longer and/or improves quality of life [1, 2]. If a treatment neither extends life nor improves its quality, we...


Breast Cancer Prostate Cancer Chronic Obstructive Pulmonary Disease Thyroid Cancer Autopsy Study 
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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Robert M. Kaplan
    • 1
  1. 1.UCLA School of Public HealthLos AngelesUSA

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