BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6965.1382 (Published 19 November 1994) Cite this as: BMJ 1994;309:1382

Minerva has a low opinion of the legal system in Britain (expensive and unreliable), but the one in the United States seems even worse. Anxiety about possible litigation by aggrieved patients has led several chemical companies to stop selling polymers to medical implant manufacturers (Science 1994;266:726-7). Makers of, for example, blood pumps and joint replacements are looking for alternatives, but the hope is that legislation might be introduced to protect suppliers of raw materials. Whether any legislation will emerge from Washington after the Republican landslide this month is another question.

Some curious results have emerged from a study of smoking in mothers, and children reported in the “American Journal of Public Health” (1994;84:1407-13). The adolescent daughters of women who smoked during pregnancy were more likely to smoke than the daughters of nonsmokers, even when the data were controlled for current smoking by the mothers. The authors suggest that nicotine might affect the fetus, perhaps by an input into the dopaminergic motivational system.

One of Minerva's anxieties about the NHS reforms is that they seem to discourage the referral of patients to specialists. Is it always a good idea that more patients should be treated …

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