Abstract
The opportunity to discuss frankly the problems in risk-benefit decisions in patient care is encouraging and illuminating. However, all that has been said, very clearly indicates how difficult it is to get it right. We all recognize that most patients do survive to a reasonably old age although some, of course, are in discomfort. This introduces the issue about how the patient with a painful condition sees the costs and benefits. It does not do justice to medical treatment to denigrate it to the extent of thinking that it is a waste of time because people are not deriving any benefit from it. At large, people at the very worst survive their medical treatment.
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