Medicine and the marginalised

BMJ 1999;319:1589-1590 ( 18 December )

Editorials

Medicine and the marginalised

They deserve the best, not the poorest, care

The first 150 words of the full text of this article appear below.

And though I have the gift of prophecy, and understand all mysteries, and all knowledge; and though I have all faith, so thatI could remove mountains, and have not charity, I am nothing.

Corinthians 13:1

Who, Christian or not, could disagree? The idea of paying special attention to "the poor and mean and lowly" is a centralpart of the Christmas story and of most religions. It is a beliefthat underpins medicine. Yet it is a belief that is constantlyforgotten. Medicine usually fails marginalisedpeople.

It is more than a quarter of a century since Julian Tudor Hart's famous paper on "the inverse care law" $---$ that those who needmedical care the most are the least likely to get it.¹ Thelaw is seen in its most extreme form on a global scale: the highestrates of sickness and premature death are in the developing world,whereas . . . [Full text of this article]

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