When becomes more in fact less?

When becomes more in fact less?

The principles ‘in dubio abstine’ and ‘primum non nocere’ are as least as old as the language they are written in, and have been made very concrete in criticisms on iatrogenesis, medicalization, polypharmacy and polypragmasy. Clinical decision analysis [1], health technology assessment, and critical appraisal of clinical evidence [2] have provided useful methods to translate these principles in...

Introduction: When More Becomes Less

When ‘more for less’ becomes ‘less for less’: the implications of central decision-making for the delivery of frontline services

With his unique perspective on the public sector, the Comptroller and Auditor General, Sir Amyas Morse, explains some of the elements of financial management and planning that determine success in major reform programmes. He uses examples from local government, adult social care, and NHS reforms to conclude that, too often, ‘efficiency’ improvements have shaded over into unplanned grass roots s...

When Less is More

engine and airframe manufacturers for decades have cited the direct relationship between engine wear and high exhaust gas temperature (EGT) in recommending that operators use less than maximum takeoff thrust whenever possible. While the cost benefits of reduced-thrust takeoffs are thoroughly documented, the safety benefits are not as well understood. Thus, there is a common perception that usin...

When Less is More.

minimum level. Sometimes more really is more, and less really is less. But often, less is more. If all this piece does is open up the question of whether less is more —if all it does is remind the reader that this is a question, and that our answers to it have important repercussions— then it will have served its purpose. Many ethicists in the ancient tradition argued that human lives could be ...