Abstract
Preceding chapters show the increasing concern among Western governments about the spiralling costs of modern high technology medical treatment and investigation, and among professionals about indefinite struggles to maintain life in moribund patients. Because of its emotional overtones, public discussion tends to be muted in the case of cancer, but physicians are well aware of gross contrasts between Europe and the USA in the aggressiveness of management in the advanced cancer patient. These differences reflect marked contrasts in the goals of treatment and they obviously affect the cost of treatment, whether it is borne by the patient or the state.
This is a preview of subscription content, log in via an institution to check access.
Preview
Unable to display preview. Download preview PDF.
References
Alper, P. R. (1987) Medical practice in the competitive market. New Engl. J. Med., 316, 336
Aaron, H. J. and Schwartz, W. H. (1985) The Painful Prescription; Rationing Hospital Care, The Brookings Institution, Washington, D.C.
Black, N. (1986) Consumer representation in the National Health Service. Brit. Med. J., 293, 976
Bowen, O. R. (1987) What is quality care? New Engl. J. Med., 316, 1578–1580
Cowan, J. A. (1986) Administrative waste in US health care. New Engl. J. Med., 315, 1034
Daniels, N. (1986) Cost containment, justice and provider autonomy. New Engl. J. Med., 314, 1380–1383
Editorial (1986) Improving use of clinical resources. Lancet, 2, 319–320
Editorial (1987) Why doctors must grapple with health economics. Brit. Med. J., 294, 326
Egdahl, R. H. and Taft, C. H. (1986) Financial incentives to physicians. New Engl. J. Med., 315, 59–61
Fein, R. (1986) Medical Care, Medical Costs: The Search for a Health Insurance Policy, Harvard University Press, Cambridge, Mass.
Gough, I. R., Furnival, C. M. and Burnett, W. (1981) Patient attitudes to chemotherapy for advanced gastro-intestinal cancer. Clin. Oncol., 7, 5–12
Harvey, I. M. and Roberts, C. J. (1987) Clinical guidelines, medical litigation and the current medical defence system. Lancet, 1, 145–147
Houts, P. S., Yasko, J. M., Kahn, S. B., Schelzel, G. W. and Marconi, K. M. (1986) Unmet psychological, social and economic needs of persons with cancer in Pennyslvania. Cancer, 58, 2355–2361
Jennett, B. (1987) Waiting lists; a surgeon’s response. Lancet, 1, 796–797
Kearsley, J. H. (1986) Cytotoxic chemotherapy for common adult malignancies; ‘the emperor’s new clothes’ revisited. Brit. Med. J., 293, 871–875
Klein, R. (1984) Rationing health care. Brit. Med. J., 289, 143–144
Lister, J. (1986) The politics of medicine in Britain and the United States. New Engl. J. Med., 315, 168–174
Lock, S. (1986) Self help groups; the fourth estate in medicine. Brit. Med. J., 293, 1596–1600
Mackillop, W. J., Ward, G. K. and O’Sullivan, B. (1986) The use of expert surrogates to evaluate clinical trials in non small cell lung cancer. Brit. J. Cancer, 54, 661–667
Miller, F. H. and Miller, G. A. H. (1986) A procrustean perspective. New Engl. J. Med., 314, 1383–1387
Schwartz, W. B. and Aaron, H. J. (1984) Rationing hospital care. New Engl. J. Med., 310, 52–56
Silberman, H. R. (1986) Minimising the economic hardships. In: Physicians Guide to Cancer Care Complications (Ed. J. Laszlo), Marcel Dekker, New York, pp. 15–35
Silver, G. (1987) Discordant priorities. Lancet, 1, 1195
Wanzer, S. H., Adelstein, S. J. and Cranford, R. E. (1984) The physician’s responsibility towards hopelessly ill patients. New Engl. J. Med., 310, 955–959
Editor information
Editors and Affiliations
Copyright information
© 1988 The Editor and the Contributors
About this chapter
Cite this chapter
Stoll, B.A. (1988). Saying No is Difficult in Cancer. In: Stoll, B.A. (eds) Cost Versus Benefit in Cancer Care. Palgrave, London. https://doi.org/10.1007/978-1-349-09296-3_12
Download citation
DOI: https://doi.org/10.1007/978-1-349-09296-3_12
Publisher Name: Palgrave, London
Print ISBN: 978-1-349-09298-7
Online ISBN: 978-1-349-09296-3
eBook Packages: MedicineMedicine (R0)