Intended for healthcare professionals


Balancing the benefits and harms of care

BMJ 2004; 329 doi: (Published 01 July 2004) Cite this as: BMJ 2004;329:59
  1. Anna Donald, honorary fellow in epidemiology
  1. University College London

    Can patients have too much information about the benefits and harms of treatment? Until a year ago, I wasn't sure of the answer to this. Why worry people needlessly about outcomes that are rarer than hen's teeth? And why burden junior staff with lengthy consent forms?

    Having just spent the past 12 months being treated for breast cancer, I am now convinced that people need as much good quality information as they can get. Why?

    Firstly, I wanted to optimise my prognosis by making good decisions. Less obviously, I wanted to be able to comfort myself post hoc that I had made the best decisions possible at the time. (It would be cold comfort were my family and I later to discover reliable research favouring different decisions than was available last year.)

    Secondly, I needed to recognise the effects of treatment, both good and bad, when they occurred. For example, being aware that neutropenia below about 0.5x109/l carried a small but real risk of …

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