Reducing the harm from medical care.

When I was a pediatric trainee just over 30 years ago, almost every child I admitted to the hospital with acute lymphoblastic leukemia (ALL) died. Today, almost all kids with ALL live. It’s a miracle. And ALL heads a long and growing list of diseases whose courses have been changed dramatically by advances in technical health care, from heart attacks and kidney failure to cold sores and bad knees. But, for these gains we pay a toll, not just in money but in risks. The audacity of modern medicine has brought with it the double edge of audacity, itself – new harms we cause in the exploitation of our new capacities. When children with ALL die nowadays, it is more often from their treatment than from their disease. (January 2008)