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Larry Rees: Cancer is the best way to die? You couldn’t be more wrong

23 Jan, 15 | by BMJ

Larry ReesAs an oesophageal cancer survivor of nine years—and now a terminal pancreatic cancer patient—I was deeply offended by Dr Richard Smith’s recent blog post in The BMJ, in which he stated that “dying of cancer is the best death” and concluded with “let’s stop wasting billions trying to cure cancer.”

My first reaction was to pen a scathing attack on the author and publisher who, in my humble opinion, acted irresponsibly, resulting in a global media frenzy that focused on those shocking sound bites.

But another recent media debate—this time around the barbaric massacre at the Charlie Hebdo offices in Paris—reminded me that the right to offend is a fundamental principle of freedom of speech. more…

The BMJ Today: Trust me, I’m a patient

23 Jan, 15 | by BMJ

peter_doshiMichel Foucault had much to say—mostly critical—about medicine. But the rarity of any mention of his name in medical journals tells me that medicine has had far less to say about him, perhaps unsurprisingly. Why engage with a philosopher, especially one who suggested in no indirect terms that medicine was inherently political, that the medical interaction was fundamentally a power relationship in which patients were objectified and brought under control? more…

Doug Altman: Author overboard—arbitrary limits at journals

22 Jan, 15 | by BMJ

doug_altmanRecently I was bounced off the authorship of a letter to the editor. I had been one of four authors of a research paper published in a leading medical journal. Subsequently the journal received a critical letter from a reader, and I contributed to our joint response. After submitting our reply we learnt that the journal has an absolute rule that letters cannot have more than three authors, so (as the one who contributed least to the main paper) I had to be omitted. What is the point of such a limit? And how does it square with the ICMJE’s rules on authorship—“all who meet the four criteria should be identified as authors.” Well, it seems that that applies only if there aren’t too many of them. more…

The BMJ Today: Hinchingbrooke, Circle, and tabloid smears

22 Jan, 15 | by BMJ

gareth_iacobucci2The recent news that England’s first privately run NHS hospital was to be placed into “special measures” by healthcare regulator the Care Quality Commission has sparked a fierce and rather ugly political debate.

As The BMJ first reported on 12 January, Hinchingbrooke Health Care NHS Trust in Cambridgeshire—managed by Circle Healthcare—was subject to the action after a CQC inspection highlighted serious failings with the hospital’s emergency and medical care services. more…

Mihail Călin: Romania’s alcohol policy leaves public to fend for themselves

21 Jan, 15 | by BMJ

Mihail_CălinA woman holding a toddler in her arms falls in a ditch while trying to recover her beer bottle from the ground. She tries to get back up, only to fall on top of her child. Moments later, she leaves her two children (one of whom is now holding his mother’s bottle) on the side of the road to argue incoherently with those filming her. The next day, she would explain her behaviour by saying she had been drinking some liquor and wine on an empty stomach after work.

This is just a more notable episode—it even made it into the British media—in the endless story of alcohol related harm in Romania. With an average consumption level of 14.4 litres of pure alcohol per year for each adult—21 litres if you count out the abstainers—Romania is the fifth largest drinker in the world and the second largest in the EU, according to the latest data from the World Health Organization. more…

Sarah Kessler interviews Atul Gawande

21 Jan, 15 | by BMJ

Sarah KesslerAtul Gawande, surgeon, author, and indie DJ (check his Twitter feed for mini playlists between the policy), just delivered the Reith Lectures for BBC Radio 4.

Broadcast to more than 50 million people worldwide, “The Future of Medicine” ranged across the UK, the United States, and India in a quest to navigate “the messy intersection of science and human fallibility.” more…

The BMJ Today: Should I prescribe anti-virals to prevent flu for nursing home patients?

21 Jan, 15 | by BMJ

helen_macA news story last week reported scepticism about whether GPs should prescribe anti-viral neuraminidase inhibitors osteltamivir and zanamivir to prevent flu in nursing home patients. Yesterday afternoon, another news story said that some GPs feel pressured by Public Health England to do so. The chair of the BMA’s General Practitioner’s Committee’s Clinical and Prescribing Subcommittee, Andrew Green, has said: “Nobody can compel you to do it, but nobody can advise you not to either.” So, as a GP, if the decision to prescribe is mine, how will I decide? more…

Christmas Appeal: Hitting the ground running—surgical transfer in South Sudan

20 Jan, 15 | by BMJ

Lanice JonesI arrived in Juba, the capital of South Sudan, on 2 January for two whirlwind days of being briefed on my new role as medical specialist in Yida refugee camp, which is at the northern edge of South Sudan. On Sunday, my rest day before flying north, I was asked to help arrange care for a young boy who was arriving by MSF plane from a project not far from my own.

Lanice Jones, MSF medical specialist © Lanice Jones/MSF more…

Desmond O’Neill: Older drivers and medical fitness to drive

19 Jan, 15 | by BMJ

desmond_oneillDoes life really imitate art, or is it the other way round? Listening to an exhilarating live performance by the Philadelphia Orchestra of Till Eulenspiegel’s Merry Pranks, the droll tone poem about a famous trickster by Richard Strauss, I was struck by the notion that this might be the first description of ADHD through music. more…

The BMJ Today: Management consultants are like Marmite

19 Jan, 15 | by BMJ

rich_hurley“It must be comforting to live in a Manichaean world where management consultants are devils and doctors are angels,” posted Stephen Black, a confessed management consultant for a “major management consulting firm that often works for the NHS,” on thebmj.com yesterday. “It makes solving the many problems of the NHS so easy.”

He was responding to a recent Personal View by David Oliver, a visiting professor, at London’s City University, which was his call to “Stop wasting taxpayers’ money on management consultancy for the NHS.” more…

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