Intended for healthcare professionals

Letters Questions before guideline use

Guidelines in the context of medical ethics

BMJ 2019; 364 doi: (Published 12 March 2019) Cite this as: BMJ 2019;364:l1040
  1. Laura J Waters, consultant in genitourinary/HIV medicine1,
  2. Simon Collins, advocate2,
  3. Marta Boffito, consultant and HIV service lead3
  1. 1Central and North West London NHS Trust, Mortimer Market Centre, London WC1E 6JB, UK
  2. 2HIV i-Base, London, UK
  3. 3Chelsea and Westminster Hospital, London, UK
  1. lwaters{at}

We fully support patient choice but question the wisdom of “walking away” from guidelines based solely on patient preference.1 All treatment decisions should be considered in the context of all four pillars of medical ethics: beneficence, non-maleficence, autonomy, and justice.2

Using examples from our field of sexual health and HIV we can apply “is this what my …

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