Is it really possible to give informed consent in the middle of having a heart attack? Most people with acute myocardial infarction are just too ill to give fully informed consent, but the author of an editorial in Heart (2004;90: 1237-8) argues that “consent is a state of mind, a decision by a patient.” In these circumstances a patient may make a decision with very little knowledge, but with a lot of trust in the doctor. It's the dialogue between doctor and patient that is critical, and it must be pitched at a suitable level for the patient.

The number of medical conferences held worldwide each business day has jumped by a whopping 50% in just 12 months. A press release for the medical industry conference Calendar Newsletter reports this as the conference business returning with a vengeance—but many budgets for travel and meetings have been frozen or reduced, making it likely that attendance figures at each meeting will drop by about half. Minerva wonders if anyone can prove a 50% increase in the “proven benefit to health” and suspects that the equivalent expenditure could be better spent.

Mild anaemia in older people is relatively common and most of it can't be easily explained, but it shouldn't just be put down to normal ageing. Even mild levels of anaemia have …