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Narcissus, Pogo, and Lew Thomas' Wager

Roger J. Bulger, MD
JAMA. 1981;245(14):1450-1454. doi:10.1001/jama.1981.03310390050021.
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I have seen the enemy and he is us.—Pogo

ANY ANALYSIS of ethical issues in health policy has to begin with the distressing admission that our civilization's fundamental values are now in question and that what social critics and psychiatrists are calling "narcissism" is undermining our society. As I tried to get excited about attempting an explication of one or another of the ethical issues in health policy, I found myself returning to the four major words in the society's name: "society," "health," and "human values," and a growing feeling that there are higher-priority questions our nation and civilization must settle before the ethical issues in health policy can be sensibly addressed. Thus, I am led to offer a personal view of our situation, painting with broad strokes from a variety of sources in the hope that there might be some implications for action.

'Narcissism'  Just as in


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