A UK Supreme Court ruling could increase damages for children negligently brain damaged at birth.1Previously young children could claim damages for earnings lost through not being able to work, but an Appeal Court ruling in 1981 limited the period of lost earnings to the years they are expected to live. Many have a shortened life expectancy because of their injury.Supreme Court judges have now overturned that decision, allowing lost earnings to be claimed for the full period the child, if uninjured, would probably have worked and received a pension.The 10 year old girl at the centre of the case, who cannot be named, has severe spastic cerebral palsy as a result of a brain injury from when she was born at the Royal Hallamshire Hospital in Sheffield in 2015.She has pain and spasms, profound learning difficulties, severe visual impairment, respiratory impairment, and epilepsy, and has a life expectancy of 29....

Atrocities carried out by paramilitary forces in western Sudan as they laid siege to the city of El Fasher have the “hallmarks of genocide,” a fact finding mission for the United Nations has said.Evidence shows that the Rapid Support Forces (RSF) in the Darfur region carried out targeted killings, sexual violence, starvation, torture, and “systematic humiliation” of non-Arab communities with the goal of wiping them out, the mission concluded.12“The RSF acted with intent to destroy, in whole or in part, the Zaghawa and Fur communities in El Fasher,” said Mona Rishmawi, a member of the mission. “These are the hallmarks of genocide.”Sudan has been beset by war for two decades, but conflict escalated in 2023 when the RSF and Sudan’s national army stepped up their battle for control of the country. An estimated 150 000 people have been killed and 14 million displaced since April 2023, making it the largest...

A total of 130 measles cases have been confirmed in England so far this year, with 34 cases reported in the past week, the UK Health Security Agency (UKHSA) has said.1The agency warned that some children have had to be admitted to hospital, and has urged parents to ensure their children get vaccinated.So far this year 103 cases have been reported in January and 27 in February (as of 16 February). Because of the time lag involved when confirming cases through laboratory testing, the true number is likely higher, the UKHSA said.Just under 1000 total cases were reported across England last year,2 with 88 reported in January and 68 reported in February 2025.The recent increase has largely been driven by an outbreak in north London.3 So far 50 cases have been confirmed in Enfield, while Haringey has reported 10 cases. For comparison, Enfield reported just 14 confirmed cases in all...

Before planning a new clinical trial, a systematic review of existing trials on the topic is essential for an evidence based approach to identify the knowledge gap and to best inform the design of the new trial.123 However, several studies indicate that systematic reviews are underused when planning clinical trials.456789 Reasons include researchers’ perceptions that they are experts in the field who know all relevant research, the fact that systematic reviews are typically time consuming, a lack of specific funds or personnel with suitable expertise, no enforcement by funders and ethics committees, and insufficient awareness and knowledge about systematic reviews.7 Failure to consider existing evidence, however, can result in unnecessary or poorly designed trials, put participants at risk, waste valuable resources, and diminish the public’s trust in science.5691011121314151617Rapid reviews are “a type of systematic review in which components of the systematic review process are simplified, omitted, or made more efficient...

Doctors who face spiralling student loans believe that they may never own a house or have children, the BMA has warned.Union leaders say that doctors now face losing 10% of their income over their working lives in a “broken” system that has left some regretting their choice to study medicine entirely.Speaking to The BMJ, Callum Parr—deputy chair of the BMA’s UK Resident Doctors Committee—said that he personally had £120 000 of student debt, which had grown from the initial £90 000 he borrowed despite him making payments towards it.“I’m from a working class background. I went to a state school. The only way that I could become a doctor, the first doctor in my family, is by borrowing what is now £120 000 and paying that off for the next three decades,” he said. “I don’t think I would have made the same decision knowing what I know now, to...

Was Emily Brontë familiar with sexual choking? From Emerald Fennell’s reimagining of Wuthering Heights, you’d think so. Fennell’s film, among its other questionable choices, panders to the current fashion of “normalising” strangulation during consensual sex. Depictions of sexual choking in media, popular culture, and pornography glamorise it and “erroneously portray it as safe,” explain Anousha Victoire and colleagues, when the effects of neck compression can be serious and life threatening (doi:10.1136/bmj.s275).1In general, do we sufficiently challenge normalised behaviour in ourselves or others? Four doctors and two nurses were charged with criminal damage for breaking windows at the European headquarters of the financial services firm JP Morgan in London—considered to be the largest financier of fossil fuels to the tune of several billion dollars, including projects in the Amazon.2 A jury trial in 2024 returned a hung verdict. A retrial has now delivered a unanimous jury verdict of not guilty (doi:10.1136/bmj.s323).3The...

In September 2025 a patient sent a digital inquiry to the GP Rachel James’s surgery in south London. The patient had presented at an emergency department the night before, had been discharged, and was asking for an urgent referral to a specialist. James was able to access the emergency department’s notes stating the diagnosis and advice for the patient to contact their GP for a routine referral if symptoms worsened.James messaged the department back, saying that she and the patient could talk about the issue at an appointment the patient had booked on the surgery’s system for the following month. Two days later, however, the patient submitted another inquiry through the Accurx digital communication tool, begging the GP for a referral because of abnormal results from their hospital blood test.The patient’s concern and persistence stemmed from them being able to see their blood results on MyChart, a patient facing digital...

The General Medical Council (GMC) is appealing to the High Court against a decision clearing a British-Palestinian plastic surgeon of support for terrorism and for the proscribed organisation Hamas.A medical practitioners tribunal last month found that allegations against Ghassan Abu-Sitta over a 2018 newspaper article and two reposts on Twitter (now X) were not proved.1 But the doctors’ regulator will argue at the High Court that the article and one retweet did support violence and/or terrorism and that the other retweet supported a proscribed organisation and terrorism.However, the GMC is not challenging the tribunal’s decision that the comments in the article were not proved to be objectively antisemitic.A GMC spokesperson said, “Exercising our right of appeal is something we do with great care and only after detailed consideration. Our focus is protecting the public, and we are satisfied given the nature of the allegations that it is right that we...

A study claiming that substituting nurses for doctors in a host of hospital settings is not only safe and effective but sometimes better for patients has critical flaws, experts have warned.Furore erupted last week when the results of a Cochrane evidence review1 were presented and then reported in the media. The review examined the effects of substituting nurses for doctors in a range of hospital settings.Researchers from Ireland, the UK, and Australia examined 82 randomised studies involving more than 28 000 patients across 20 countries. Their meta-analysis reported “little to no difference” between nurse led and doctor led care for critical outcomes, including mortality, quality of life, self-efficacy, and patient safety events.The studies included four types of interventions in different clinical settings where nurses of various seniority replaced doctors in specialties such as cardiology, diabetes, cancer, obstetrics/gynaecology, and rheumatology. The four interventions were:Inpatient services, where nurses looked after post?acute medical...

Artificial intelligence (AI) plays an increasing role in medical diagnosis, particularly in image recognition. In cancer pathways, AI tools are already established in mammography screening, where they can improve diagnostic performance and increase efficiency.12 But we need to consider what happens and who is responsible when AI gets it wrong.Cancer specialists have long used clinical decision aids in diagnosis and treatment. Initially based on published evidence or guidelines, decision support tools are now regulated as medical devices and products, such as the PREDICT3 breast cancer survival and treatment model, and have had to achieve both professional acceptance and regulatory compliance.Although there are no reported cases to date where an AI model has contributed to a delay in cancer diagnosis, it is inevitable that their use will come up in cases where a cancer is missed or a misdiagnosis leads to unnecessary investigations or treatment. In certain circumstances, claimants will still...

bmj;392/feb18_11/s326/FAF1faJulia Kochetova/MSFAs the war in Ukraine reaches its fourth anniversary, the charity Médecins Sans Frontières is marking the Russian invasion with a series of pictures taken by the award winning Ukrainian photographer Julia Kochetova.With more than four million people internally displaced, MSF teams consistently see that the last to leave their homes are often the most vulnerable: elderly people, young families, and people with illnesses. Kochetova has captured portraits of these people—such as Zinaida Babisheva and her dog Toshyk (pictured)—forced to survive in strange towns after being evacuated from their homes.

bmj;392/feb18_1/s295/FAF1faDaniel was born in Bristol to Sarah Stone and Colin Money, both teachers. He grew up in nearby Keynsham with his older brother, Joe, and younger sister, Freya. Daniel attended the Wellsway secondary school and, with an interest and aptitude for maths and science, he decided at an early age to become a doctor.As well as studying hard, Daniel was a talented sportsman. He excelled at hockey and tennis to county level and played badminton, football, and cricket, and swam for local Keynsham clubs.Daniel studied medicine at the University of Birmingham Medical School where he played a big role in medical society activities: playing with cricket and tennis clubs; becoming president of the hockey club; and directing and performing in the comedy revue. Covid stopped his planned elective in Vanuatu but he worked in hospital throughout the pandemic, supporting qualified staff, and graduated in 2021.Daniel completed his first foundation year...

Six doctors and nurses who cracked windows at JP Morgan’s European headquarters in London in protest against the bank’s funding of fossil fuels have been unanimously acquitted of criminal damage by a 12 strong jury.The jury members at Snaresbrook Crown Court in London delivered their not guilty verdicts after a retrial, following a 2024 trial at which a jury was unable to reach a verdict.1The four doctors and two nurses—who include the GPs Patrick Hart and David McKelvey, consultant obstetrician Alice Clack, and consultant psychiatrist Juliette Brown—are all members of Health for XR, a group of health workers supporting the environmentalist movement Extinction Rebellion.In July 2022, during a record heatwave, the group broke windows at the financial services firm JP Morgan, causing nearly £200 000 worth of damage. Two days later the UK recorded its hottest day ever at 40.3°C.Hart said in his closing speech to the jury at the...

US president Donald Trump says he has finalised rules to revoke the legal basis for emissions regulations related to climate change.Scientists and environmental lawyers have condemned the move, labelling it a rejection of scientific logic that will harm human health.US regulations on emissions that cause climate change hinge on a 2009 finding by the US Environmental Protection Agency (EPA) that greenhouse gases endanger human health and welfare. This “endangerment finding” means the EPA must regulate these gases under the rules of the 1970 Clean Air Act.But on 12 February the EPA announced1 that it had “finalised its rescission of the 2009 Greenhouse Gas Endangerment Finding.”The EPA statement reads, “Absent this finding, EPA lacks statutory authority under section 202(a) of the Clean Air Act to prescribe standards for greenhouse gas emissions.“Therefore, EPA also finalised the repeal of all subsequent greenhouse gas emission standards from its regulations for light, medium, and heavy...

The NHS has a longstanding ambition to bring down hospital clinic waiting times, and the cheapest way is by reducing referrals.1 Some referrals are simple, and the patient’s problem might be solved by a written exchange between GP and hospital specialist—usually through the advice and guidance (A&G) option on the e-referral system. The GP writes a brief outline of the case, including a succinct clinical question, and a specialist replies.At NHS England’s board meeting in early February, the national director for planned care spoke of A&G as a cornerstone of “outpatient transformation” and said that it would become mandatory in the top 10 specialties in each region.2 This has raised concerns: does this mean that it must be available in those specialties—or that it must be used before any referral?3 The latter implies that although GPs may wish to refer, the specialist will decide whether the patient is offered an...

AbstractObjectiveTo evaluate whether vitamin D supplementation improves live birth rates in women with polycystic ovary syndrome undergoing in vitro fertilisation.DesignMulticentre, double blind, placebo controlled, randomised clinical trial.Setting24 fertility centres in China.Participants876 participants with polycystic ovary syndrome undergoing in vitro fertilisation.InterventionsParticipants were randomised (1:1) to receive vitamin D 4000 IU/day or placebo before in vitro fertilisation for up to 90 days until the trigger day.Main outcomes measuresThe primary outcome was live birth after the first embryo transfer. Secondary outcomes included serum 25-hydroxyvitamin D (25-OHD) levels on trigger day, pregnancy outcomes, fertility outcomes, and adverse events including severe ovarian hyperstimulation syndrome.ResultsOf 876 participants randomised, 865 were included in the modified intention-to-treat analysis, with 435 in the vitamin D group and 430 in the placebo group. Baseline mean serum 25-OHD levels were 16.5±7.2 and 16.1±6.7 ng/mL in the vitamin D and placebo groups, respectively. On the day of triggering, the serum 25-OHD level was significantly higher in the vitamin D group than in the placebo group (32.3±11.2 v 18.2±7.6 ng/mL, adjusted mean difference 13.6, 95% confidence interval 10.9 to 16.3). 226 (52.0%) live births occurred in the vitamin D group and 216 (50.2%) in the placebo group (adjusted risk ratio 1.03, 95% confidence interval 0.91 to 1.18). Severe ovarian hyperstimulation syndrome occurred in three and six participants in the vitamin D and placebo groups, respectively (adjusted risk difference ?0.7%, 95% confidence interval ?2.0% to 0.6%).ConclusionsAlthough vitamin D supplementation (4000 IU/day) for up to 90 days increases serum 25-OHD levels, this does not translate to improved live birth rates after the first transfer for patients with polycystic ovary syndrome.Trial registrationClinicalTrials.gov NCT04082650

Abdosamad was born in Damavand, Iran. He qualified from Tehran University in 1957 and moved to the UK in 1959 to train in pathology and develop his interest in research. In 1965, after being awarded his doctorate, he became a lecturer at University College Hospital, London. This was an ideal post, allowing him to indulge in the parts of his work that he most enjoyed: pathology, research, and teaching. His research included work on the then recently observed retinal and pulmonary pathologies affecting pre-term neonates and related it to their management with high oxygen concentrations. He was also proud of his work on hepatic and pancreatic regulation of blood glucose levels.He divided his passions between pathology and politics and the 1960s and 70s saw the peak of his political activity. There were many groups opposed to the dictatorship of the Shah of Iran and my father, who was principled and...

bmj;392/feb17_6/s292/FAF1faRoger was raised in a small flat in Leytonstone, east London, and worked as a hospital porter before starting at Westminster Medical School. While at medical school he spent time working with the Flying Doctors’ Service in Lesotho and South Africa. His first role in the UK as a qualified doctor was as a house physician at Westminster in 1974 under Richard Bayliss, the queen’s physician. Subsequently, he worked for six months under Roy Calne, the organ transplant pioneer, at Addenbrooke’s Hospital in Cambridge.Roger was then recruited by the British Council to undertake a year’s posting to run the hospital on Gan Island in the Maldives, following the withdrawal of the Royal Air Force. This posting, and the high rates of asthma on the island, spurred his interest in respiratory medicine.Next came work in Bordeaux, Edinburgh, Newfoundland, Papua New Guinea, Sierra Leone, and the United Arab Emirates, followed by a...

On 17 November JAMA Internal Medicine published a study1 estimating that 383 clinical trials had been terminated after sweeping US government budget cuts2 led the National Institutes of Health to end their grant funding suddenly and unexpectedly.The study estimated that over 74 000 participants had been affected. One researcher, studying the effect of PrEP prevention drugs, told the Washington Post that he “firmly” believed that some of the participants enrolled in that trial would have been infected with HIV without the drugs from the study.Related articles on bmj.comHow China became the new world leader in clinical trials (BMJ 2026;392:s221 doi:10.1136/bmj.s221)India has overtaken the US on clinical trials but struggles with regulation (BMJ 2026;392:s219 doi:10.1136/bmj.s219)Clinical trials bring new treatments to market. They also determine which practitioners get to train with cutting edge technology, who has first access to new treatments, and where jobs and investment migrate. Data published in November 2025...

Men must avoid letting “stigma and embarrassment” put their health at risk, the UK drugs regulator has said in a warning about fake erectile dysfunction pills.The Medicines and Healthcare Products Regulatory Agency (MHRA) said that analysis has shown many seized pills contained no active ingredient, the wrong dose, or hidden drugs or toxic ingredients.UK officials have taken nearly 20 million illegally traded erectile dysfunction drugs off the market in the past five years, including a record 4.4 million in 2025 alone.Unlicensed erectile dysfunction drugs can be especially dangerous for people with heart disease or high blood pressure, or those taking other drugs, and can raise the risk of heart attack, stroke, and low blood pressure, the regulator said.Erectile dysfunction affects around half of men aged 40 to 70. The MHRA said research suggests that two in five men would avoid seeking medical advice and instead opt for unsafe online sellers.Andy...