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================================================================================ BMJ Defames the Dead-Once Again!Many would have seen the recent obituary of Dr David Horrobin which appeared in the BMJ. It is clearly, one of the nastiest things the BMJ could have done to anyone after death. The hurt that that obituary had caused Dr Horrobin's family, friends, and many others from around the world is vividly displayed in the large number of rapid responses that followed. Sadly, the editor of the BMJ had condoned this utterly defamatory and seemingly inaccurate account of late Dr Horrobin. In attempting to justify the BMJ's conduct, the editor tries to draw an analogy with style of writing in an autobiography which he claims to have read; one would say, that is where he has 'missed the bus' completely. Unfortunately, reading autobiographies or knowledge acquired via a thousand books will be no replacement to genuine understanding of the word 'sympathy', and its application. Why is the BMJ so extravagant in its desire to defame deceased doctors and cause severe distress to their grieving families? It was only last year that the BMJ embarked on a similar assault on another distinguished doctor, late Prof Dame Sheila Sherlock. There were similar protests to what we have seen in relation to late Dr Horrobin with inaccuracies pointed out promptly, but seemingly, all in vein. Sadly, it gives the clear impression that the BMJ is determined to exploit the weaknesses of the UK libel laws, in total disregard of those who are in an acute state of grief. Why is this BMA-owned journal has become so callously cruel to some of its deceased members and their loved-ones, so soon after one's demise?; isn't it time that we heard an explanation from the BMA itself, rather than from its ever-defensive editor? Whilst some answers are needed to fathom the real motives behind the BMJ's morbid desire to libel the dead, one wonders who will be the next victim. Perhaps, the BMJ should print a warning aimed at its doctor-readers and their loved ones, that post-death libel will be published in its obituary columns. Those who are further interested in this unpleasant subject, could carry out a search for "defaming dead", and you may find, among others, some comments of Dr Harold Shipman which fall under this category. So it is not just the BMJ which seems to be prone this problem. Further research might be needed to understand the pathophysiology of those who seek to defame the dead; 'Defamatory Obituary Syndrome (DOS)' might be an apt name for this condition, and the readers are asked to nominate potential sufferers by emailing [email protected] so that we may follow them up in a systematic manner. Who knows, "snake oil" might be a cure for DOS; after all, the BMA will be very familiar with venomous attacks given a snake prominently twists around its ancient logo. Medical-Journals.com wish to convey their deepest sympathies to the family of Dr David Horrobin. April 2003 ====================================================================================================================
============================================================================================== Dame Sheila Sherlock Re: Obituary Prof. Dame Sheila Sherlock 31 January 2002(Rapid Response) Anna S.F. Lok, Email Anna S.F. Lok, et al.: To the Editor: British Medical Journal In her overly abundant zeal your contributor Caroline Richmond has done a profound disservice to the memory of Dame Sheila Sherlock (obituary,BMJ: Jan 19,2002 ).As representatives of the large group of N.American expatriates trained by Dame Sheila we wish to protest the innuendoes, aspersions and opinionated gossip included in Richmond’s assessment of the life and work of this outstanding clinician, scientist and teacher. Dame Sheila trained and mentored many hundreds of aspiring hepatologists and not one of us would be where we are now if not for her guidance and support. She gave this support unconditionally and although this was not invariably reciprocated with loyalty from every quarter she never in our experience bore a grudge or maligned any of her prot�g�s. She may not have forgotten Maurice Pappworth’s personal attack on her but we doubt that she was unable to forgive. As for alleged one-way criticism, Sheila loved the cut-and-thrust of medical and scientific debate, and could take as much as she gave in this arena (witness some of the early Medical Research Society question times). She taught us to think on our feet and respond to tough questions with the best available evidence based data. In our individual experiences of up to 40 years as her trainee, colleague and friend we never saw her ignore patient feelings, and as for good taste, by what criteria or evidence does Caroline Richmond offer herself as arbiter on the relationships that Sheila had with her patients? They loved her authoritative consultations borne of lifelong experience; her compassion was expressed openly to both patient and concerned family and advice was proffered firmly but supportively. In addition, in contrast to prevailing traditions Sheila was blind to class or wealth and treated all her patients with equal dedication. She would not have laid claim to the introduction of liver biopsy as stated by Richmond. Rather Sheila developed and exploited its capabilities to the ultimate in clinicopathological correlation and with Prof. Peter Scheuer presiding she taught us just what a valuable tool it could be in the management of patients with parenchymal liver disease. Finally, in a lamentable lapse in factual reporting Caroline Richmond fails to give the correct recognition to Mandy James, Sheila and Gerry’s older daughter, and the Baptist minister, for presiding at Dame Sheila’s funeral. As an early Editor of Gut, one of the BMA’s proud publications, Sheila would in her inimitable style have sent Caroline Richmond away with a missive to rewrite her copy and get the facts right, young lady! We believe that you owe Dame Sheila Sherlock’s memory and her family an apology. Signed: ----------------------------------------------------------------------------------------------- Dame Sheila Sherlock Email: I write in response to the obituary of my mother, Dame Sheila Sherlock. So far obituaries have appeared in the Independent, Times and Guardian newspapers and it has made me very proud indeed of my mother. However, Caroline Richmond has failed to produce an accurate one. May I take this opportunity of pointing out a number of factual errors: 1. My mother did not write the first textbook on hepatology and would be the first to give that credit to the correct author. 2. My mother did not introduce needle biopsies but she used the late Sir John McMichael's technique. 3. I conducted the funeral service and not my younger sister, Auriole. 4. It is totally inaccurate to state that the family are reticent about her cause of death. My mother died very peacefully in her sleep on Sunday December 30 of Fibrosis of the lungs. The writer of this obitaury was told that. To say that I am upset about this obituary is an understatement. At a time when I am grieving the loss of my mum, to read such an obituary, enrages me and has done a number of my mother's colleagues. The fact that my father has received over 200 letters of sympathy from all over the world, possibly indicates the love and affection people had for my mother. I trust that you will make these inaccuracies known. Amanda Sherlock James (Rev) ------------------------------------------------------------------------------------------------- Getting more for their dollar: a comparison of the NHS with California's Kaiser... Problems with the comparison 21 January 2002(Rapid Response) Azeem Majeed, Email Azeem Majeed: Email Azeem Majeed: [email protected] I agree with Samer Nashef that this paper contains a serious methodological flaw, namely the correction for purchasing power parity, which inflates NHS costs by a factor of 1.52. The reason why the NHS has lower salary, prescription and procedure costs than the USA is integral to the way in which the NHS works. Hence, the lower cost of health services in the UK should not have been adjusted for. The NHS also takes on many functions not provided by US health plans such as Kaiser Permanente. The authors did try to correct for this by reducing the NHS costs by 6%, but a more valid solution would have been to increase the Kaiser Permanente costs by including a proportion of the costs of the US Department of Health & Human Services, Federal agencies such as the Centers for Disease Control and the Agency for Healthcare Research & Quality, the costs of training health professionals, and the costs of the Californian public health system. Other problems with the paper include the very crude adjustment for age and socio-economic status. Once these methodological problems are corrected for, the conclusions of the paper about the cost- effectiveness of the two systems will change markedly. The other striking difference between the two healthcare systems, the substantially lower number of bed days in the Kaiser Permanente system than in the NHS, should also be treated with caution as detailed information on how the number of bed days was calculated has not been given. The BMJ should not have allowed publication of this measure unless the authors were able to provide detailed definitions about what constitutes a ‘bed day’ in each system and how the average number of bed days was calculated. -------------------------------------------------------------------------------------------------------- Heavy drinking by young British women gives cause for concern John Duffy, Email John Duffy: I have noticed that the BMJ seems to have a critical 'blind spot' when it comes to reporting survey-based research (see for example corresondence following BMJ 2000; 320: 982-984). This seems to be the latest example, and I am responding reluctantly as this letter appears now to be taken seriously by more than just the BMJ editor. Apart from the ludicrous over-interpretation of very small numbers, the highlighted result is not particularly new or surprising. The Health Survey for England 1996 found that the youngest women had the highest proportion drinking more than 35 units per week - so no surprise there. What might be interesting is that the youngest men (who had the highest proportion of drinkers of over 50 units per week in the Health Survey) now appear *not* to be the group consuming most dangerously. However, the method of sample selection (quota rather than random)would not generally be recommended for a survey of alcohol consumption or indeed any scientific survey as it does not allow valid application of statistical tests(even if the data were treated as arising from a random sample statistical analysis would not support the points made by the authors). The method of respondent 'capture' (sampling points) would also seem inappropriate - is it just that young heavy drinking men can't be bothered to give interviews about their drinking in the street? Reworking the denominators from the percentages in the table we find that elderly women(65+) certainly *do* seem to like to be interviewed. Unless there is a mistake in the published table, there must have been about 300 of these in a sample of 1052 women. Where does this leave the quota controls? Before leaping to the conclusion that this is all the fault of 'senior statistician' Bill Mason, I should say in his defence that Bill is not, nor does he claim to be, a statistician of any kind, and was surprised to find himself so described by the authors. </cgi/eletter-submit/323/7322/1183?title=Re%3A+Surveys+-+BMJ%27s+blind+spot%3F> ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ Meeting the needs of chronically ill people Email Richard Smith: Peter Lapsley points out that our theme issue on chronic disease included nothing on skin disease. We will make sure that the next theme issue on chronic disease does, and we will also consider a theme issue specifically on skin disease. Such an issue might consider why skin disease is so consistently forgotten. Richard Smith, Editor, BMJ http://www.bmj.com/cgi/eletters?lookup=by_date&days=3#323/7319/945/EL6 ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ PAPERS Communication difficulties during 999 ambulance calls: observational study Higgins et al. (6 October 2001) [Full text] Communication difficulties during 999 ambulance calls: observational study BMJ Refereeing and Studies of Medical Interaction 5 October 2001(BMJ Rapid Response) Professor Robert Dingwall; Dr Alison Pilnick, Professor of Sociology; Lecturer in Sociology University of Nottingham Email Professor Robert Dingwall; Dr Alison Pilnick: [email protected] The apparent eccentricities of the BMJ's refereeing of work on medical interaction have long been observed by those of us who do research in this field. We have noted the tendency to publish work based on discredited models of language and social behaviour that shows no awareness of the extensive and sophisticated body of literature that the social sciences have produced on these topics. The paper by Higgins et al is a particular case in point. Emergency communication - 911 calls - has been studied in some depth by a number of US authors, particularly Jack and Marilyn Whalen, with various collaborators and students, and recently by Garcia and her students. This literature established the extent to which communication problems are collaboratively produced by callers and despatchers trying to align their accounts of the incidents being reported. These problems are often magnified by the disjuncture between the 'rational' organisation of reporting demanded by computer-assisted despatching systems and the 'everyday' organisation of story-telling adopted by callers. This is a quite different understanding of the problem than merely blaming callers for being 'emotional' and leads to rather more useful recommendations for despatcher training and the design of computer systems. In essence, these need to be better adapted to the way callers present information rather than assuming that callers in an emergency situation can be made to report in ways that fit the technology. The actual means of communication -mobile or landline - plays a relatively small part in these difficulties. This US work has not so far found much replication in the UK, although it is informing current research on NHS Direct. However, it would seem reasonable to expect that the paper's authors or the BMJ's referees should have been aware of it and to suggest that the journal's readers might have been better served by a more rigorous process of review. | |||||||||||||||||||||