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OBSERVATIONS: Iona Heath Dare to use your own intelligence BMJ 2008; 337: a1319 [Full text]

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Straw clutching.

Simon D Price   (26 August 2008)

"I was only obeying orders"

GH Hall   (26 August 2008)

Re: "I was only obeying orders"

David G Tucker   (27 August 2008)

Straw clutching. 26 August 2008
Simon D Price, GP Newport np10 9hw Send response to journal: Re: Straw clutching.	The drowning man may clutch at a straw only to find that NICE have plucked it from the water. There are times when even faint hope is worth trying. I fully support NICE but exceptions should be allowed. Competing interests: One day I may die of cancer.
"I was only obeying orders" 26 August 2008
GH Hall, Retired physician EX1 2HW Send response to journal: Re: "I was only obeying orders"	Heath is right. Guidelines provide a good excuse not to make individually determined decisions. "The man in Whitehall knows best." It is fully understandable that practitioners heave a sigh of relief when the latest directives come from on high. But the experts must be identifiable, accessible, answerable and respond to questions quickly and honestly. Anyone who has tried to get the truth about the safety and efficacy of current influenza vaccines, for example, will know how difficult this is. Or,why are the out of date Framingham equations still used in cardiovascular risk assessment? This is the area where a bit more soul searching and scientific humility is badly needed. One recalls the old gibe- "Just because something is approved by all the experts it doesn't necessarily mean it is wrong." Incentives, however, as in the QOF payments, are highly suspect ethically. Even the GMC condemns them (for drug firms but not government) if they persuade doctors to do something they would not otherwise do. This rather begs the question "Why otherwise would they be offered?" Competing interests: None declared
Re: "I was only obeying orders" 27 August 2008
David G Tucker, Therapist hants SP10 Send response to journal: Re: Re: "I was only obeying orders"	My thoughts entirely. I have been tryng, with no success whatsoever, to obtain vaccine efficacy figures and vaccine status data, for the usual regular vaccines and relevant patients.The HPA have been ignoring my requests for status figures, which I believe they collect and collate from notification forms. Maybe someone here can help with this please? It unsurprisingly creates much wonder as to why efficacy and 'breakthrough'...(what a quaint phrase that is!)data are not widely available.One would expect a vaccine's 'highly effective' label to be independently verified...then again, maybe not. If I was producing a product with amazing success rates I would shout about it....not keep bringing out 'new and improved' versions. Perhaps it is me and I am at fault for missing something here? Competing interests: None declared