Oral contraceptives, venous thromboembolism, and the courts

doi:10.1136/bmj.325.7363.504

BMJ 2002;325:504-505 ( 7 September )

Editorials

Oral contraceptives, venous thromboembolism, and the courts

There has to be a better way of resolving claims about adverse effects

The first 150 words of the full text of this article appear below.

Controversy is an inevitable element of medical progress, but sometimes it degenerates into doubtful disputations. Duringthe 1950s, as evidence mounted about the exceptionally strongassociation between smoking and lung cancer, ingenious theorieswere advanced about bias or confounding in the epidemiologicalstudies. Sir Ronald Fisher, the renowned statistician, describedthe notion that cigarettes can cause lung cancer as "a catastrophicand conspicuous howler."¹ It is small wonder that consensusis slow to develop about much weaker associations between drugs(or contraceptives) and adverse events. A recently completed trialin the English High Court raises the question of whether the judicialprocess can help us reach sensibleconclusions.

The action was brought against three pharmaceutical companies by women who believed they had been harmed by third generationoral contraceptives. In October 1995, the United Kingdom's Committeeon Safety of Medicines announced that such contraceptives (containingdesogestrel or gestodene) carried a higher . . . [Full text of this article]

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