Intended for healthcare professionals

This Week In The Bmj

…but such findings are likely to be confounded by disease severity

BMJ 2006; 332 doi: (Published 01 June 2006) Cite this as: BMJ 2006;332:0-a

Legal problems of randomised trial of parenteral penicillin in meningococcal meningitis

In an ideal world the benefit of parenteral penicillin given as an
emergency measure in meningococcal meningitis is clearly of great
importance and deserves to be definitively established by a controlled
clinical trial.

However, given that over the years significant numbers of doctors
have been sued,successfully,for vast damages for having failed for one
reason or another to administer parenteral penicillin in such cases,it is
difficult to see how such a trial could ever be carried out.

Which Doctor is going to risk the legal trauma involved in refraining
from such treatment, and which lawyer is going to allow such a
financially ruinous opinion as might result from demotion of parenteral
therapy to see the light of day?

We have become, I fear, for better or worse, enmeshed in a culture
where such questions are usually decided by trial in the Courts, not the
controlled trials of clinical medicine!

Competing interests:
None declared

Competing interests: No competing interests

02 June 2006
Michael H Martin-Smith
GP Principal
Sydenham House,Boulevard,Hull HU3 2TA