PEDIATRICS Vol. 83 No. 4 April 1989, pp. A40
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OPINION IS NOT GOOD ENOUGH

Student

Clinical freedom is dead, and no one need regret its passing. Clinical freedom was the right-some seemed to believe the divine right—of doctors to do whatever in their opinion was best for their patients. In the days when investigation was non-existent and treatment as harmless as it was ineffective the doctor's opinion was all that there was, but now opinion is not good enough. If we do not have the resources to do all that is technically possible then medical care must be limited to what is of proved value, and the medical profession will have to set opinion aside.

Clinical freedom died accidentally, crushed between the rising cost of new forms of investigation and treatment and the financial limits inevitable in an economy that cannot expand indefinitely. Clinical freedom should, however, have been strangled long ago, for at best it was a cloak for ignorance and at worst an excuse for quackery. Clinical freedom was a myth that prevented true advance. We must welcome its demise, and seize the opportunities now laid out before us.