The BMJ's ethics committee is open for business
BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7297.1263 (Published 26 May 2001) Cite this as: BMJ 2001;322:1263
All rapid responses
Dear Editor
I read with interest the minutes of your ethics committee meeting and I
congratulate you for taking a bold stand against unethical and harmful
research. Cruelty towards humans and animals in the name of research may
have been acceptable practice in the past but it has to be abolished now.
However this practice still continues.
I was disappointed to read an article in the New England Journal Of
Medicine(1) where the researchers describe explicitly how they applied
blunt trauma with a wooden object to the chests of pigs at various points
of cardiac cycle and induced ventricular tachcardia which was on a few
occassions fatal. Evidence based medicine states that such research cannot
be generalised to humans and considering that a blunt trauma to a pig's
chest is a very unusual occurence I wonder if this article is of relavence
to anyone!(except vets with interest in pig cardiology) How such research
involving cruelty to animals managed to get into a leading medical journal
beats me?
I hope other journals take your lead and discourage such research.
Yours truly
Dr S Geethavani MBBS
Refs
1) Link MS, Wang PJ, Pandian NG et al. An experimental model of sudden
death due to low energy chest wall impact. N Engl J Med 1998;338:1805-11.
Competing interests: No competing interests
Hmmmmm ... speaking of evidence ...
1. I am not a lawyer but a practising physician specialized in
general internal medicine
2. The quote attributed to me by Dr. Fenton is not something I said
and is not attributed to me in the minutes of the ethics committee meeting
posted on BMJ's website
3. My view on this case, as detailed in those minutes, was: "This
patient is the victim of a medical mistake. Naming, shaming, and blaming
(ie telling the patient she has grounds to sue) is the wrong approach if
we want to move on from the blame culture in medicine and acknowledge that
mistakes happen because of faulty systems, not people. Taking steps to
change the system is a more progressive approach." Other people had
different views which also made sense to me.
4. My views on medical error were also aired in a recent BMJ
commentary where I argued that " ... we should cherish each mistake as an
opportunity for improvement. This will require a change in medical culture
from an ethic of personal responsibility to one that also values the
safety of patients and the improvement of quality. Senior consultants will
need to lead this charge by what they say and do. The "lesson to all of
us" is that we should learn to love mistakes because they carry in them
the kernel of their own elimination. " (see
http://www.bmj.com/cgi/content/full/322/7296/1236)
5. There are some other errors of fact in Dr. Fenton's letter
6. So, sadly, I conclude that Dr. Fenton's letter on evidence based
journalism is not evidence based
7. I commend BMJ for starting its ethics committee and posting the
minutes on the website. I strongly believe that readers who disagree with
the committee's conclusions or the views expressed by individual members
should post their responses so I am grateful to Dr. Fenton for posting the
first such response.
Competing interests: No competing interests
Dear Sir,
Re: The BMJ's ethics committee is open for business
We make mistakes, in medicine as elsewhere. We
don't enjoy making mistakes, but usually learn not to
make the same mistake again. We become more
experienced.
Our colleagues will usually know the details of the
mistake, and will learn too. If there is an important
lesson to be learnt, an interested member of the team
will usually discuss the case at a local or larger
meeting, and, if the lesson is of particular importance,
submit a paper for publication in a journal with the
relevant readership.
Peter Singer, a lawyer on the BMA's new ethics
committee, was told of a paper submitted to the BMJ in
which a patient had her ophthalmological diagnosis
missed by her local DGH, which referred her to a
tertiary centre. Unfortunately, the patient was almost
totally blind by the time she was seen there.
No doubt there is a medical lesson to be learnt here.
The BMJ's editors choose not to tell us what it was, but
to judge and scold. They say 'we decided instead to ask
the authors to discuss this patient and her poor
outcome with the referring hospital, making it clear that
we would take things further if they didn't.' The paper's
authors gave a robust response to this misguided
reaction.
What lesson did I get from the editorial? Just that I
should advise people who have written up a 'lesson of
the week' case not to submit it to the BMJ, but to a
journal concerned with education of doctors, and to the
common good.
Peter Singer states that ''the only way this patient can
get the compensation she needs to alleviate her
disability is by suing the hospital for negligence'. He's a
lawyer, so would say that (and where's the evidence).
Doctors, thank goodness, have a more forward-looking
and less adversarial approach to solving problems.
Yours faithfully,
Dr Theo HM Fenton
Consultant Paediatrician
Mayday Hospital,
London Road,
Croydon,
Surrey CR7 7YE
Competing interests: No competing interests
"Lighthearted" Sexism for Christmas
In what the Associated Press describes as its "traditionally lighthearted" Christmas issue, the British Medical Journal offers the "results" of a blatantly sexist and scientifically irresponsible "study" of the physical dimensions of women used as Playboy centerfolds since 1953.
Noting that the BMJ has appointed an ethics committee to oversee what it publishes, one must wonder what this committee understands about ethics if its members think that engaging in sex politics at women's expense is ethically honorable behavior. Must abuse hurt men to be visible to these alleged ethicists?
There is nothing lighthearted about pimping and the BMJ has damaged its credibility by this action.
Twiss Butler
Alexandria, VA
Competing interests:
None declared
Competing interests: No competing interests