Soundings Soundings

St Mark's guideline

BMJ 1999; 319 doi: (Published 10 July 1999) Cite this as: BMJ 1999;319:133
  1. James Owen Drife, professor of obstetrics and gynaecology
  1. Leeds

    Dear Chaplain, It has been brought to the attention of the trust guidelines committee that you are distributing a booklet entitled The Gospel According to St Mark. The committee has obtained a copy and has requested comments from the relevant departments. Several concerns have been raised.

    1. In the title, “gospel” should be changed to “guideline.” “Gospel” implies inflexibility. With a guideline, however, adherence is closely monitored and persistent deviation results in this committee providing supportive counselling for the deviant.

    2. In chapter 3 the selection criteria for disciples are unclear. The human resources director has pointed out that no person specification was available. This is likely to generate adverse comment in relation to the lack of gender and ethnic mix. Were these posts properly advertised and were structured interviews carried out?

    3. The feeding of the five thousand (chapter 6) produced a positive response from the contract caterers, but the research director raised several questions. He advises that the subjects should have been randomised using sealed envelopes into two groups of two and a half thousand, one of which could have received five loaves and the other two fishes.

    4. In chapter 2 a patient is instructed, “Arise, and take up thy bed, and walk.” This caused considerable concern to both the physiotherapy department and the trust equipment manager. The patient should have been advised to turn on his left side and put his feet to the floor before arising. The guideline should also say, “Even if thou feelest well, thou shouldst not arise unless accompanied by a nurse or health care assistant. Thy walking will be assessed by the occupational therapist. Thy bed should be left for the next patient.”

    5. Finally, after a computerised literature search using the keyword “gospel” the committee's research assistant identified three other publications not referenced in your guideline. Please check if any further gospels have been published as abstracts or conference proceedings. We would ask you to combine the four published gospels (plus any unpublished ones) by formal meta-analysis.

    We look forward to receiving a revised draft which can be distributed with the full authority of this committee.

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