More Military Might
"The Battle For Baghdad" [September 4] warrants a new plan. The United States should put 500,000 more troops on the ground in Iraq. Such an overwhelming force will end hostilities there in short order. Two aircraft carrier battle groups should then enter the Strait of Hormuz that separates Iran from the Arabian peninsula. This would undoubtedly get the attention of Iran and Syria, and sanctions would not be needed for the Iranians to stop uranium enrichment. The U.S. military must be rebuilt as President Ronald Reagan did before. A Selective Service Act should be re-enacted by Congress to increase and train manpower. A good side effect of a draft would be registering illegal aliens.
BARRY TOPCIK
Tamarac, Fla.
Hoopla Over Homework
"A New Case Of The Old Back-To-School Blues" [September 11] gave validation to the frazzled young families I talk to now that the new school year has begun. Mothers don't want to nag their kids to do homework after 5
DEANNA ENOS
Folsom, Calif.
House Cleaning
In "House of Horrors" [September 11], the question is asked: "What will it take to get Congress to get tough on itself?" The answer does not rely upon Congress at all. Voters should forget about political posturing and ploys and in every election, from local to national, vote the incumbent out! A minority of honest, ethical, valuable politicians would lose office, unfortunately. But the effects will be minimal compared with the benefits and the realization that political office is not a career.
J.W. WEITZELL
Las Cruces, N.M.
"House of Horrors" Should be required reading for everyone before voting in an election again. Voters should think of our Founding Fathers. When they signed the Declaration of Independence, they understood the last words on that document: "We mutually pledge to each other our Lives, our Fortunes and our Sacred Honor." They worked for a free nation while spending their own fortunes, not the public's money to benefit themselves. These men had pride, honor, and integrity, little of which seems to be present in the majority of current representatives. If these representatives cared about the country, they would resign, allowing dedicated people to take over, and then limit total terms to eight years. Professional politicians turn a democracy into an inflated bureaucracy.
JACK FERGUSON
Marietta, Ga.
Evaluating the Evidence
Bernadine Healy is partly right about evidence-based medicine when she concludes: "EBM has its merits, but let's make it just what it claims to be: a system to gather and synthesize evidence and disseminate it widely in order to enhance medical decision making. Do so using the full range of relevant medical knowledge and science and the foremost thinking of its experts, without political or ideological bias. This 'best' EBMshould be integrated into medicine, not be at odds with it" ["Who Says What's Best?" September 11]. This is what EBM is trying to accomplish and has been all along. This characterization, however, omits one key aspect of evidence-based thinking: the recognition that evidence, whether strong or weak, is never sufficient to guide clinical decision making. Evidence informs us of the benefits, risks, and burdens associated with management alternatives, and evidence-based thinking helps evaluate the strength or weakness of that evidence. Individual values and preferences must balance these upsides and downsides to arrive at a decision that is right for the individual patient.
R. BRIAN HAYNES, M.D., PH.D.
GORDON H. GUYATT, M.D.
McMaster University
Hamilton, Ontario
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