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Editorials

Judging the benefits and harms of medicines

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j3129 (Published 30 June 2017) Cite this as: BMJ 2017;357:j3129

Rapid Response:

Re: Judging the benefits and harms of medicines

It is good to see that the first recommendation of the Academy of Medical Sciences is to involve patients, carers, and the public in research as a means of tackling concerns about the erosion of public trust, overmedication and conflicts of interest (1). It is important however, to note that patient and public involvement is already an imperative for much publicly funded UK health research and has been so for some time. Also, to note that the field of involvement is not outside of or immune to conflicts of interest or the erosion of trust; especially given that such involvement is often reduced to time consuming and tokenistic box ticking exercises (2).

Following O’Neill (3), the aim should be for more trust in the trustworthy and less in the untrustworthy, not for more trust across the board. This requires building, and in some cases rebuilding, trustworthiness in health research and its processes and practices of involvement. It is unhelpful that discussions on the placement and refusal of trust in health research continue to be infused with a pervasive 'deficit model' which implies that all public and professional scepticism of science is unfounded and that there is a need for corrective communication by experts, rather than a need to encourage broader debate that attends to those concerns (4).

1) http://www.bmj.com/content/357/bmj.j3129
2) http://journal.frontiersin.org/article/10.3389/fsoc.2017.00007/full
3) https://www.ted.com/talks/onora_o_neill_what_we_don_t_understand_about_t...
4) http://rsnr.royalsocietypublishing.org/content/early/2016/09/12/rsnr.201...

Competing interests: No competing interests

06 July 2017
Mary Madden
Lecturer in Applied Health Research
University of Leeds
School of Healthcare, Faculty of Medicine and Health, 2.19, Baines Wing, University of Leeds, Leeds LS 2 9JT.