Your Hospital Cafeteria: 7:40 AM Dr Williams: I need to fill you in on Mrs Smith. Dr Hart: Oh, yes, I remember her. Breast cancer, about 2 years ago. I saw her family in the hall yesterday. How is she? W: Unfortunately, she's gotten worse. She now has metastases to the liver and bone. H: Oh, dear, she's such a lovely woman. What's next? W: Well, I want to try high-dose chemotherapy with autologous bone marrow transplantation. I've told her about the 10% treatment mortality, about the high complication rates and side effects, and that there are no controlled trials showing benefit, but it's her only hope. H: Will her insurance company cover it? W: We're lucky there. Her employer is self-insured. They've agreed to cover the costs from an employee-funded health promotion fund. Apparently they don't want the bad publicity some of the other insurers have gotten when they've
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David M. Eddy (1991) studied this question.