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Where's the Evidence?Debates in Modern Medicine$
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William A. Silverman

Print publication date: 1999

Print ISBN-13: 9780192630889

Published to Oxford Scholarship Online: September 2009

DOI: 10.1093/acprof:oso/9780192630889.001.0001

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A ‘win’ in medical Russian roulette

A ‘win’ in medical Russian roulette

(p.196) 45 A ‘win’ in medical Russian roulette
Where's the Evidence?

William A. Silverman

Oxford University Press

This chapter presents a 1997 commentary on the extracorporeal membrane oxygenation (ECMO) trial for neonates with respiratory failure. The ECMO experiences shows that there are significant national differences in the factors and dynamics that come into play in the spread of high-cost, high-tech, high-risk modern interventions in medicine. It addresses the question: How can we balance the technical challenge of perfecting hardware for life-support against medicine's humane imperative to avoid needless pain and suffering?

Keywords:   randomized trials, clinical trials, medical practice, extracorporeal membrane oxygenation, neonatal care

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