BMJ  2004;329:47-50 (3 July), doi:10.1136/bmj.329.7456.47

Education and debate

Making decisions about benefits and harms of medicines

Trisha Greenhalgh, professor of primary health care1, Olga Kostopoulou, Department of Health R&D/PPP national primary care postdoctoral fellow2, Clare Harries, lecturer3

1 Department of Primary Care and Population Sciences, University College London, London N19 5LW, 2 Department of Primary Care and General Practice, University of Birmingham, Birmingham, 3 Department of Psychology, University College London, London

Correspondence to: T Greenhalgh p.greenhalgh@pcps.ucl.ac.uk

Even when good scientific data are available, people's interpretation of risks and benefits will differ

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

Introduction

Drug regulatory authorities, such as the Medicines and Healthcare Products Regulatory Agency in the United Kingdom and the Food and Drug Administration in the United States, award product licences by assessing the balance between benefit and harm. The decision to revoke a licence generally hangs on evidence of lack of efficacy or risk of serious adverse effects, taking account of the seriousness of the condition and the range of other treatments available.

The authorities work at the level of the whole population. But individual patients may believe (rightly in some cases) that a particular regulatory decision is not in their own best interests, and vociferous campaigns sometimes result (box 1). Involvement of patients can be a powerful driver for improving services.5 But both lay people and professionals are susceptible to several biases when making health related decisions (box 2). What can be done to ensure that the care of individual . . . [Full text of this article]

Sources and selection criteria

Individual need versus population level policy

Cognitive and social influences on risk decisions

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Narrative influences on decision making

Conclusion


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Balancing benefits and harms in health care: Ethical dimension was not discussed in theme issue
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