But very little of medicine falls into that absolute category. Many of our treatments haven’t been rigorously studied, and even if they have, large swaths of the population are woefully underrepresented in clinical trials — the very old, the very sick, women, members of racial and ethnic minorities, children, pregnant women and those low on the socioeconomic scale.
Much of the time, therefore, we function in an ambiguous zone, without clear-cut answers. My patient didn’t fit perfectly into the “high-risk” category, and he was from an ethnic minority that wasn’t well represented in the I.C.D. trials.