Do no harm and do more good for those who need it most

“Do no harm.” Medicine's first rule. But it can be so easy to do harm. On p 266 a group from Oxford investigate the effects of neuroleptic drugs on elderly patients with dementia. In the United States–perhaps because of its “grey panther” movement–there has been great anxiety about the overprescribing of neuroleptic drugs to elderly people in nursing homes. Federal laws prohibit their use for behaviour such as wandering, restlessness, or insomnia. In Britain the anxiety is just beginning, but a BMJ paper showed that many people in nursing homes …