bmj;389/apr17_21/r745/FAF1faVicky Evans played a leading role in developing the discipline of forensic medicine as an academic specialty, establishing a training programme as well as professional standards and competencies: elements that were missing when she began working as a police surgeon, as forensic physicians were known when her career began in the 1980s.She was also instrumental in establishing standards of care for those who had been sexually assaulted, as one of the first four female physicians to be recruited to St Mary’s Sexual Assault Referral Centre (SARC) in Manchester in 1986. The centre—the first in the UK and only the second in the world after Perth, Western Australia—was founded by GP Raine Roberts and heralded a revolution in the treatment of those making allegations of rape or sexual assault.Before this, treatment was patchy. Victims would be seen in police stations, sometimes with the perpetrator of the assault in the next room....

The UK Supreme Court has ruled that doctors in two children’s end-of-life cases may be named, to allow the parents to tell their story about what happened to them and their child in hospital and in court.1The court lifted High Court injunctions barring anyone for an indefinite period from naming the doctors involved in the cases of Zainab Abbasi and Isaiah Haastrup. The children were at the centre of High Court disputes between their parents and NHS trusts over whether it would be in their best interests to receive life sustaining treatment. Isaiah died aged 12 months in 2018 and Zeinab at the age of 6 in 2019.Robert Reed and Michael Briggs, delivering judgment in the Supreme Court, said that injunctions should be for a limited period only. They said, “A reasonable duration would be until the end of the proceedings and, in the event that they terminate with the...

Doctor or physician?I was surprised when I first learnt, some time ago, that in the summaries of product characteristics (SmPCs; previously called data sheets) of certain drugs it is specified that they should be used “at the discretion of the physician,” often when advising about use in special groups, such as pregnant women or children. Surprised, not because advice was required, but because a physician was specifically required, not just any doctor. Indeed, I estimate that the term “physician” occurs 3–4 times more often in such sources than the word “doctor.” Furthermore, the two terms often seem to be being used interchangeably. In at least one case, for example, they were used as if they were synonymous, with advice that the product was to be used “under the direction of a physician” followed almost immediately by the instruction that “if the usual dose [was] less effective or its duration of...

The UK population’s health is getting worse. Health inequalities are widening and obesity rates rising, particularly among children in deprived areas (doi:10.1136/bmj.q2819 doi:10.1136/bmj.r525 doi:10.1136/bmj.q2457 doi:10.1136/bmj.r593).1234 A new investigation by The BMJ explores the influence of industry on some of these trends (doi:10.1136/bmj.r667).5The investigation finds that the advertising industry is lobbying local authorities to delay or scrap plans to ban junk food advertising on bus stops and billboards, using well rehearsed industry tactics of “deny, delay, and dilute.” With many local authorities facing significant debts, advertising companies are warning councils of the financial impact of restricting junk food advertising, telling them that they risk a substantial drop in advertising revenues. The areas targeted have some of the highest rates of childhood obesity in England. As a result, some councils have already paused or restricted plans to ban advertising of foods high in fat, salt, or sugar.The government is leaving local authorities...

On 16 September 2024 Jimi Olaghere became the first person with sickle cell disease to reach the summit of Mount Kilimanjaro. The 39 year old could hardly believe it as he contemplated his achievement from nearly 6000 m above sea level.“I was in shock. Five years ago, I couldn’t get out of bed,” Olaghere tells The BMJ. People with sickle cell disease are discouraged from venturing to areas above 3000 m, let alone to the top of Africa’s highest peak.Olaghere was one of the participants in Vertex Pharmaceuticals’ trial of exagamglogene autotemcel (exa-cel, brand name Casgevy), which works by editing a patient’s blood stem cells before they’re re-injected. In the phase 3 trial 29 of 30 (97%) participants with repeated vaso-occlusive crises—episodes when “sickled” red blood cells get stuck in blood vessels and cause pain—reported no crises and no related hospital admissions for at least a year.1Exa-cel isn’t the only...

The UK government has launched an independent review to examine how hundreds of children in England were given a misdiagnosis by NHS hearing services.1Camilla Kingdon, a consultant neonatologist at the Evelina London Children’s Hospital and former president of the Royal College of Paediatrics and Child Health, will lead the review of how service failures in paediatric audiology led to many children’s hearing tests not being conducted properly or followed up effectively.So far, 107 children have been found to have been given a misdiagnosis from 2018 to 2023, and a further 2000 children are being re-examined.2Commenting on the launch of the review, a spokesperson for the Department of Health and Social Care said, “Families across the country have been let down by unacceptable failings in paediatric audiology, exacerbated by a culture that has buried problems instead of tackling them.“NHS England has been recalling children for testing as quickly as possible, and...

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