Intended for healthcare professionals


Pressure mounts for inquiry into MMR furore

BMJ 2004; 328 doi: (Published 26 February 2004) Cite this as: BMJ 2004;328:483

Richard Smith said it best!

Richard Smith argues for parents' right to choose over single
vaccinations or MMR.

(Editor's Choice)
Abusing patients by denying them choice

"It first hit me that denying patients choice is a form of abuse when
about six years ago I read a paper on patient choice in screening for
colorectal cancer. One hundred Californian patients were given full
information on five options…. Patients were told about the nature of the
test, the preparation required, the need for sedation, the time required,
how often the test would be repeated, the likely results with both
positive and negative outcomes in detail, and the cost. The result was
that patients chose very different options.

"Steve Woolf, a family physician and North American editor of the
BMJ, wrote: "Suppose these same 100 patients had not received this
information and were instead cared for by a physician who routinely
performs flexible sigmoidoscopy because he considers it the best test.
According to these data, fully 87% of the patients would undergo a
procedure other than the one they would prefer if properly informed" ( J
Fam Pract 1997;45: 205-8[ISI][Medline]). Nine out of 10 patients have been

"Some 15-20 years ago an editorial in the BMJ suggested that every
menopausal woman should have hormone replacement therapy. That now looks
like bad advice….
The main arguments against fully informing patients are that 'It's too
difficult, costly, and time consuming.' But they are neither evidence
based nor politically sustainable."
(BMJ 2004;328 (14 February), doi:10.1136/bmj.328.7436.0-f )

Medical history is littered with treatments that caused more harm
than good yet supposedly intelligent people seem incapable of learning the

Competing interests:
None declared

Competing interests: No competing interests

05 March 2004
Gurli Bagnall
Inedpendent Patients' Rights Campaigner
Marlborough Sounds, 7372, New Zealand