Facing up to uncertainties: a matter of life and death

‘Failure to face up to uncertainties about the effects of treatments can result in avoidable suffering and death on a massive scale. If when diazepam and phenytoin were iintroduced as anticonvulsants for eclampsia they had been compared with magnesium sulphate – which had been in use for decades – hundreds of thousands fewer women would have suffered and died. Similarly, if the effects of systemic steroids for traumatic brain injury had been assessed before this treatment became widely adopted, tens of thousands of unnecessary deaths could have been avoided. These are just two examples of many that might have been used to illustrate why doctors have a professional responsibility to help address uncertainties about the effects of treatments.’

Chalmers I. Addressing uncertainties about the effects of treatments offered to NHS patients: whose responsibility? Journal of the Royal Society of Medicine 2007; 100: 440.