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Jeffrey Aronson: When I use a word . . . A ban to abandon

22 Jul, 16 | by BMJ

jeffrey_aronsonRecently, Trish Groves reported in The BMJ that some conference organisers would like to ban the use of Twitter and other social media at conferences. The main concern seems to be the transmission of pictures of speakers’ slides, which may contain otherwise unpublished data. I say “otherwise” because many do not seem to realise that the presentation of data at a meeting is a form of publication. It may, for example, prevent you from obtaining a patent.

Concerns about hyping or misrepresenting results that have not been peer reviewed were also cited, but post-publication review is becoming increasingly common, and peer review has not previously prevented results from being hyped and misrepresented more…

Ilora Finlay et al: Doctors should be wary of assisted dying

22 Jul, 16 | by BMJ

This blog was commissioned following a debate on assisted dying at the BMA ARM. It is part of a collection of blogs on the topic. Jacky Davis argues that the BMA should move to a neutral position on assisted dying. Sheila Hollins et al argue that the BMA is right to reject a neutral position. In this piece Ilora Finlay et al say that doctors should be wary of assisted dying. 

 

Why should doctors be wary of what is being called “assisted dying.” Well, let’s pass over the obvious problem—that giving patients the means to kill themselves cuts right across the “do no harm principle” in medicine. Let’s look at some of the practical issues.

After nearly 20 years of legalised physician-assisted suicide in Oregon, only one in three doctors there is prepared to undertake this in practice. [1] So it’s not surprising that there is “doctor shopping,” in which patients whose doctors refuse to assist their suicides seek out or are “introduced to” a minority of willing ones who have never met them before and know nothing about them beyond the referral letter or notes. In 2015 one Oregon doctor handed out no less than 27 prescriptions for lethal drugs. [2] more…

Basil Porter: Deadly silence

22 Jul, 16 | by BMJ

basil_porter.jpgI recently returned from a fiftieth anniversary reunion of our Witwatersrand Medical School graduating class in Johannesburg, South Africa. Many had spent their careers outside of South Africa, most in the USA, Canada, Israel and the UK. During formal sessions, people were asked to talk about our student days and their subsequent lives.

A few recalled the short, surly mortician in his white coat next to the prostate corpse, who would with a flourish unknown to today’s medical students, most of whom probably have not even seen an autopsy, make a long vertical incision from sternum to pubis. All the internal organs would be laid out followed by an electric saw removing the upper half of the skull, allowing the brain to be removed and join the fellow organs. The pathologist would then enter and select a student to join him in continuing the autopsy. more…

Farewell to DECC: What does its closure mean for the UK’s commitment to tackling climate change?

21 Jul, 16 | by BMJ

In among all the recent political developments, it may have been easy to miss that the Department for Energy and Climate Change (DECC) became the latest fatality of the Cabinet reshuffle. DECC has been folded into the Department for Business, Innovation and Skills (BIS), to now become the new Department for Business, Energy and Industrial Strategy (BEIS). Removing “climate change” from the Department’s title sends out a foreboding message about the government’s commitment to combating global warming. Yet, we might also ask what is really in a name and does this actually mean a major setback for the fight against climate change? more…

Mara Evans blogs from a maternity ward in South Sudan

21 Jul, 16 | by BMJ

MaraProfile picThe day was hot and quiet. Ward rounds had finished and the local midwife and I were waiting on a woman’s seventh baby. The other midwife had just examined our labouring patient and told me she was dilating well at seven centimetres. Generally, when a person is giving birth to their seventh baby things can happen quite fast, so we were prepared for the woman to tell us when she needed to push.

Women labour next to each other in the maternity department, and mostly prefer to lay down while they do. I attempt to encourage women to walk about, as this can help with labour, but my pantomime actions are apparently hilarious, and usually not considered seriously. more…

Chris​ Simms: The Iraq war, Chilcot, and cherry picking data: How to find a way forward?

20 Jul, 16 | by BMJ

Chris_simsThe first week of July 2016 was a week to remember. A cluster of war related stories dominated the media, including the 100th anniversary of the Battle of the Somme (1 July), the death of Elie Weisel on 2 July, on 3 July there was the deadliest bombing in Bagdad since 2003, three days later we had the release of the Chilcot report and the 45 minute response it drew from former Prime Minister Tony Blair, and on 8 July the deployment of NATO troops into Eastern Europe (for the first time since the end of the Cold War).

These events tend to underscore the importance of careful assessment of past mistakes and taking measures to prevent their reoccurrence. more…

Clare Marx: Making the best of Brexit for the NHS

20 Jul, 16 | by BMJ

Change, challenges, setbacks, and advances are the hallmarks of modern medical careers. We can either let “Brexit” type moments consume us, whispering from the sidelines, or show the leadership necessary to deal with the uncertainty which now confronts us.

It is in this latter spirit that I believe the NHS must respond to leaving the European Union.

Maintaining and enticing staff to work here has to be a top priority. Over 40% of surgeons trained outside of the UK. Attracting and training more UK graduates is clearly important but losing our non-UK colleagues would be cataclysmic. Within surgical teams are the thousands of technicians, porters, and cleaners who have moved to the UK to serve our NHS. Toughened migration rules often particularly affect such groups of workers and we must send a clear message to the Government that the NHS also needs to retain these vital staff.  more…

Deborah Kirkham: Mind the technology gap—how can the NHS bridge it?

20 Jul, 16 | by BMJ

deborah_kirkhamI find the exhibition halls at conferences fascinating. They provide an interface between private and public sector which many clinicians are not exposed to in their day to day work. There’s the private companies with their baristas and artisan coffee beans; a stand that’s bigger than the square footage of an average UK home, and so many lights, screens, and colours, that one can only stand and gaze in wonder. At others, more modest organisations, or perhaps more modest public sector budgets, stretch to a branded tablecloth, a pop-up banner, and a free pen. more…

Richard Smith: What are the causes of health?

19 Jul, 16 | by BMJ

richard_smith_2014Ask doctors for the causes of heart failure or any disease, and answers will pour from them. Ask them about the causes of health or wellbeing, and they will go blank. Doctors are trained to think about disease not health.

Sir Harry Burns, formerly chief medical officer for Scotland, asks doctors about the causes of health or wellbeing to get them thinking. He shows a slide, compiled by others, of the many theories of salutogenesis, the opposite of the familiar pathogenesis. They boil down, he believes, to just six things. They are: more…

Adrian James: Why mental health treatment should only ever be “patient-first”

19 Jul, 16 | by BMJ

adrian_james2Earlier this month I spoke at a conference on Psychological Therapies for Severe and Prolonged Mental Illness in London. I was one of only two psychiatrists on the bill, among many psychologists putting forward a “therapies first” approach to the treatment of severe mental health problems.

As I said at the conference, I have a problem with this insistence on indicating a preference. And that’s not a matter of me protecting my own ground; it’s a matter of protecting patients. I’ve argued the need for more psychological therapies on many occasions. I have no interest in turf-wars. I have an interest in providing patients with the most appropriate treatment, in the most appropriate way. more…

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