Retinal vessel leakage at high altitude.

mony is a virtue to which all physicians should strive in the practice of medicine. However, we disagree with the statement in the article that “Both parsimonious medicine and rationing aim to reduce resource use.” The aim of medical parsimony is to provide the care necessary for the patient’s good, not to reduce resource use (although it may in addition preserve resources)—a difference in intention that helps form the foundation for the ethical distinction between parsimonious medicine and rationing. We suspect Tilburt and Cassel might agree because they note the role of beneficence and nonmaleficence in underpinning parsimony. But language is important, and in this case it should not confuse a well-developed rationale for parsimony in medical practice.