Introduction

Abstract

We prefer to go about our lives in uninterrupted good health. Dependably good health contributes toward our overall well-being, permitting us to work toward fulfilling more completely our life goals and desires. Even if illness can be effectively treated, when we recover we are often unable to return fully to our pre-ailment condition. From any utilitarian perspective it would seem that preventing suffering should be more highly valued than alleviating it. Yet in the US and other western nations we spend twelve times as much on treatment as on prevention. Why do we apparently prioritize alleviating harm over preventing harm? This chapter, the introduction to a volume that deals with the question of priorities between treatment and prevention from economic, cost-effectiveness, philosophical, ethical, cultural, and religious perspectives, outlines the problem and constituent issues, and introduces the reader to forthcoming chapters. It also sets forth some common terms and definitions for the volume and presents a thought experiment which attempts to isolate deontological from utilitarian considerations. The prevention-related components of the recently passed US health reform legislation, the Patient Protection and Accountable Care Act of 2010, are presented and discussed. Finally we note some limitations of this volume—questions not asked or answered that are important for future consideration.