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Views And Reviews Taking Stock

Rammya Mathew: Three questions I ask before using a guideline

BMJ 2019; 364 doi: (Published 28 January 2019) Cite this as: BMJ 2019;364:l358
  1. Rammya Mathew, GP
  1. London
  1. rammya.mathew{at}
    Follow Rammya on Twitter: @RammyaMathew

Scenes of vehement nodding are all too familiar when someone proclaims that “clinical guidelines are just guiding principles, not a set of rules to be slavishly followed.” But equally familiar is the sense of unease that sits high in one’s stomach when choosing to actively ignore them. The worry that ensues, about our decision making being called into question, has probably plagued most of us at some point.

So, although the limitations of guidelines may be widely acknowledged, when it comes to making tough choices in medicine …

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