BMJ  2005;331 (5 November), doi:10.1136/bmj.331.7524.0-f

Editor's choice

Survival of the richest

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

My brother raised an ethical dilemma over lunch last week. Should he give his private patients a prescription for Tamiflu (oseltamivir) if they ask for one while his NHS patients don't have that option? At the time I didn't have an answer, but Michael Jefford and colleagues provide some help in this week's BMJ (p 1075). Although the principle of distributive justice suggests he shouldn't offer something to some patients that others can't have, two other principles guiding medical ethics—beneficence (acting in the patient's best interests) and respect for autonomy—dictate that he should. "Doctors should be committed to the individual patient's interests and autonomy rather than their own conception of social ideals such as equity," they say.

But Jefford and his colleagues are talking in the context of drugs for which the evidence is flimsy but supply is assured. Does their answer apply where supplies of a drug . . . [Full text of this article]

Fiona Godlee, editor

(fgodlee@bmj.com)


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