End the silence on animal products in drugsBMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f722 (Published 05 February 2013) Cite this as: BMJ 2013;346:f722
- Kinesh Patel, junior doctor, London
“I am sorry, Mr Goldstein, but you are just going to have to eat your bacon for breakfast. The same goes for you Mr Khan. Just pretend it’s something else. If you don’t eat it you’ll never get better, will you?”
It sounds ridiculous, doesn’t it? We would never dream of being that insensitive to religious preferences—or other personal choices. So it strikes me as really quite odd that when it comes to drugs we actually are that insensitive. We avoid the issue of giving people products that they would refuse to put in their mouths if they knew what was in them, by simply not telling them what is in them.
As Jerome K Jerome notes in Three Men in a Boat, after inadvertently drinking water from the River Thames without harm: “What the eye does not see, the stomach does not get upset over.” In this case it’s “What the eye does not see, the sensibilities don’t get upset over.”
One culprit is Gelofusine—or, as I like to think of it, boiled beef bones in a bag. I can’t think of a scenario when it has been essential to give this to a patient because there are plenty of alternatives that are acceptable to vegetarians. Yet we never consider this. “Just squeeze in the Gelo,” is the familiar command echoing around emergency departments and anaesthetic rooms.
Drug capsules are another problem because they are principally made from gelatine derived from pork or beef. Even though drug packaging has plentiful information about allergies and so on, it makes no mention of animal products used. In the current climate, where beefburger manufacturers use our equine friends and bovine prey interchangeably, is not our duty even clearer to check what is actually in the tablets we prescribe?
About 10% of the adult UK population is vegetarian.1 Hindus, Jains, Muslims, Jews, and Buddhists might also object to some of these products. A first step to consider these patients’ interests would be to mark every drug in the British National Formulary that contains animal byproducts. Alternatively, hospitals should wean themselves off the non-vegetarian items they buy, just as they have largely done for latex. The current silence and ignorance is not defensible in a modern multicultural NHS.
Cite this as: BMJ 2013;346:f722