Intended for healthcare professionals


The antidepressant effects of eating fish and other stories . . .

BMJ 2014; 348 doi: (Published 08 May 2014) Cite this as: BMJ 2014;348:g3036

Philosophers like to argue about how clinical decisions ought to be made, while patients and clinicians have to make them within a few minutes. This was fairly simple in the days of “doctor knows best” but is very difficult within a culture that upholds patient autonomy. The latest issue of the Journal of Medical Ethics (2014;40:293-300, doi:10.1136/medethics-2011-100207) features a provocative article by Neil Levy entitled “Forced to be free? Increasing patient autonomy by constraining it.” Minerva is not entirely convinced by Levy’s argument but urges anyone interested in shared decision making to read this article and the responses to it. Clinical decision making, like science and politics, will always be a balancing act informed by values—a practical art of the possible.

Centuries before the rise of Greece and Rome, the young goddess Minerva wandered the land of Iran, learning integrity, compassion, and stewardship of the earth from the followers of Zarathustra. She still has …

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