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The Twenty-Four Hour Society: Understanding Human Limits in a World That Never Sleeps

Roy L. DeHart, MD, MPH
JAMA. 1993;270(18):2230. doi:10.1001/jama.1993.03510180100045.
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We in medicine are familiar with the 24-hour society. Our hospitals provide health services around the clock and throughout the year. Those of us on call may be required to meet the needs of our patients for 24 continuous hours and perhaps through the next clinic day without adequate rest. Illness and injury are not attentive to office hours or convenience. But are we at our best when time is ignored and rest delayed?

Dr Moore-Ede, in his short book The Twenty-Four Hour Society, suggests that when we disregard time (our body clock) and rest is inadequate, we do so at our own peril and that of our patients.

No longer are health care services, security activities, and utilities the principal 24-hour industries. Because of the international marketplace, it is always the business day somewhere in the world. International conglomerates are no longer set to eastern standard time. For some,


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