The Last Laugh

The whole truth?

BMJ 2003; 326 doi: (Published 12 June 2003) Cite this as: BMJ 2003;326:1340
  1. Phil Hammond (, writer, comedian and resting doctor
  1. Bristol BS40 8RR

    In 1871 Oliver Wendell Homes, a prominent American physician, told his medical students, “Your patient has no more right to the truth that you know than he has to all the medicine in your saddlebags. He should get only just as much as is good for him.” This information control is the foundation of medical power, but in the post-Bristol era we've decided British patients should be told “the whole truth” about their care. Do you really want to know, though? Or do you still prefer the cosy placebo of blind faith?

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    You can't find out how many times your pilot has crashed, but soon you'll know if your heart surgeon is any good. That's the theory, but our politicised NHS has always swapped accuracy for expediency. Denied the resources to produce reliable figures, heart surgeons have been bounced into releasing rough data simplified into a ludicrous “Michelin guide” star system. Just as you suspect the lone star McDonald's waiter of peeing in the milkshakes, you may not trust your bottom-rung heart surgeon.

    I feel …

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