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World Blindness and the Medical Profession: Conflicting Medical Cultures and the Ethical Dilemmas of Helping

Bradford H. Gray
The Milbank Quarterly
Vol. 70, No. 3 (1992), pp. 535-556
Published by: Wiley on behalf of Milbank Memorial Fund
DOI: 10.2307/3350134
Stable URL: http://www.jstor.org/stable/3350134
Page Count: 22
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World Blindness and the Medical Profession: Conflicting Medical Cultures and the Ethical Dilemmas of Helping
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Abstract

This is an account of a thwarted humanitarian effort and the strategic and ethical issues that it raised. Between 14 and 17 million people in the world are blind with cataract, a condition readily corrected by surgery. In 1989 a proposal was developed to attack this problem by supplying volunteer ophthalmologists to the world's leading private voluntary organizations that carry out programs in less developed countries. The proposal was rejected. This article describes the proposal and the issues on which it foundered: cost effectiveness, appropriate technology, changing ideologies of assistance, and conflict between the cultures of medicine and public health. The account illustrates the far-flung consequences of technological change in medicine, as well as the practical and ethical questions facing organizations that carry out overseas assistance programs.

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