Prevention vs. Treatment

I contributed chapter 10 in this new book, Prevention vs. Treatment.  It is otherwise quite a valuable book for health policy, public health, and bioethics.



Everyone knows the old adage, "an ounce of prevention is worth a pound of cure," but we seem not to live by it. In the Western world's health care it is commonly observed that prevention is underfunded while treatment attracts greater overall priority. This book explores this observation by examining the actual spending on prevention, the history of health policies and structural features that affect prevention's apparent relative lack of emphasis, the values that may justify priority for treatment or for prevention, and the religious and cultural traditions that have shaped the moral relationship between these two types of care.

Economists, scholars of public health and preventive medicine, philosophers, lawyers, and religious ethicists contribute specific sophisticated discussions. Their descriptions and claims lean in various directions and are often surprising. For example, the imbalance between prevention and treatment may not be as great as is often thought, and we may be spending excessively on many preventive measures just as we do on treatments compelled by the felt demands of rescue. A standard practice in health economics that disadvantages prevention, "discounting" the value of future lives, may rest on weak empirical and moral grounds. And it is an "apocalyptic" religious tradition (Seventh-day Adventism) whose members have put some of the strongest and most effective priority on long-term prevention.



Prevention vs. Treatment is distinctive in carefully clarifying the nature of the empirical and moral debates about the proper balance of prevention and treatment; the book pursues those debates from a wide range of perspectives, many not often heard from in health policy.

Features

• Compares prevention and treatment by looking comprehensively-philosophically, legally, religiously, and scientifically-at their underlying values.



• Contrary to common beliefs that prevention is lamentably underemphasized, there may be grounds in contemporary western values for prioritizing treatment over prevention, though rationally that appears to make little sense. Numerous essays in the volume carefully examine such alleged reasons for according moral priority to treatment.


• Philosopher Norman Daniels for the first time lays out a view of the prevention-treatment relationship in the context of his influential theory of justice in health and health care.


• Major religious traditions are explored for their views on the relative importance of treatment and prevention, as is the interesting intersection of western acute medicine and Confucian values in Hong Kong.