Minerva

Minerva would like to thank the astute BMJ reader who pointed out that her interpretation of the results of a paper comparing the use of an aromatase inhibitor and tamoxifen in postmenopausal breast cancer was rather more enthusiastic than it might have been (BMJ 9 January 2008; www.bmj.com/cgi/eletters/336/7634/0#186655). For clarification: the ATAC study from Lancet Oncology (2008;9:45-53) found that the smaller number of deaths after recurrence with anastrozole (245) than with tamoxifen (269) was not significant and there was no effect for overall survival with anastrozole.

Clinicians have an ethical duty to help in emergencies. But the Medical Protection Society says you should take a moment to think about your immediate mental competence. Alcohol, drugs, and tiredness can all impair competence, and you should proceed only if it is vital to do so. An emergency at 30 000 feet (9000 m) is no ordinary clinical scenario, and it’s quite likely that a doctor …