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Celebrity illness
health warning, it preempted the industry’s responsibility to warn about the dangers of tobaccos, as the manufacturers of any other product would be legally required to do. The government label should be removed. Elizabeth M Whelan American Council on Science and Health, 1995 Broadway, 2nd Floor, New York, NY 10023-5860, USA
Drugs and mental health SIR-MIND (National Association for Mental Health) appreciated your Aug 5 editorial. It is encouraging to read such a balanced piece. The debate on medication will no doubt continue, and, since MIND’s position is sometimes misrepresented, I thought I would describe it. MIND does recognise that medication can be helpful but is concerned that the adverse effects are often underestimated by those who do not experience them. Our research shows that over 60% of people taking neuroleptic drugs experience severe or very severe adverse effects. Patients were dissatisfied with the information they were given. 80% felt that they had not been told enough about their treatment generally, and 70% were dissatisfied with the amount of information on the side-effects of drugs. MIND receives many calls to its information service from people who are worried about their medication-for instance, because they have been told very little about it, or are experiencing adverse effects. We are concerned about some of the apparently poor prescribing practice which comes to light in the course of these enquiries-for example people being taken off neuroleptics or benzodiazepines abruptly, or being prescribed more than one neuroleptic drug at a time, or being put on depot medication for years without review. Although the Royal College of Psychiatrists has warned about the use of high doses of neuroleptics (and MIND welcomes this), the use of high doses seems to have become too common for that statement to be enough to stop the practice. Through our publications and information service we aim to provide full information about psychiatric drugs. One initiative, which has the support of the Committee on Safety of Medicines (CSM), is MIND’s own "yellow card scheme". This is a way for people to report suspected adverse drug reactions to the CSM via MIND. Judi Clements MIND, Granta House, 15/19 Broadway, London E15 4BQ, UK
Celebrity illness SIR-You are right in your Aug 26 editorial to focus on the issue of how the name of a patient with a particular disease enters the public domain. As a press officer who has worked within the National Health Service for 14 years I have repeatedly faced this difficulty, which is not easy. However, you mention the "well-known UK medical scientist who recently underwent treatment by a famous’ surgeon" and refer to "the spin" being "handled by the scientist’s researchfund administrator and the press office of the hospital where the patient is being treated". I run the press office at the hospital to which you refer, and note that you define the word spin as "manipulation put on a case for purposes other than the wellbeing of the patient". In this case it was the patient herself who sought the publicity, and for a disinterested motive-publicity for fundraising for the condition from which she was suffering. Many patients come forward of their own accord to help hospitals raise funds and
I cannot see any sinister behind this.
motive-your
"darker side"-
attract the interest of the work with deal with such enquiries fairly and openly, while always protecting their patients from unwelcome interest. There have been several occasions when the parents of sick children on the transplant waiting list have sought publicity, through a public appeal for a heart. That has to be their decision, but where possible we talk through with them both the downside of media attention, and the fact that relatives of other very sick children may not be happy to see one particular case hit the headlines. We never encourage such appeals, but where the family is determined to make use of media interest in this way we do our best to support them. Everyone would agree with you that more publicity should have been given to the Transplant Olympic Games.. But such publicity would clearly have named the participants. My colleagues and I always "reiterate the presumption of confidentiality in favour of the patient". But patients are also grown-up human beings who understand and sometimes even welcome press coverage.
Specialist hospitals frequently
media, and those
we
Jonathan Street Jonathan Street Public Relations Limited, London W2
Siena and
3QR, UK
operation Michelangelo
SIR-It is surprising that such scientific journal should spread intends to
an
an
important international unfounded
rumour
that
scandal, by publishing (Aug 5, clearly p 366) news on two wholly unconnected events-namely, plans for new units at Siena’s University Hospital and a police investigation into allegations of corruption elsewhere in Tuscany. create
Simini should have been more accurate and made it clear that the new units in Siena are a matter of internal organisation within the Azienda Ospedaliera di Siena and concern
highly specialised departments.
Simini mentions ophthalmology. This department has a world wide reputation and was recently asked by Italy’s prime minister to help a Bosnian child. Simini also mentions infertility; Siena’s CNR research unit on sterility in men is the only one in Italy. The other organisational principle is teaching requirements. It is not a question of creating new primariati (clinical departmental heads) but of looking at our responsibilities to patients. The Azienda Ospedaliera will not be charged unless it is demonstrated that there is a fair balance between costs and benefits over a three-year pilot
period. In replying to Simini’s letter my sole concern is that the truth is respected and the dignity of the Faculty of Medicine of the University of Siena is maintained. Piero Tosi Office of the Rector, Universitá 53100 Siena, Italy
degli Studi di Siena, Banchi di Sotto 55,
Out-of-date textbooks SiR-Weatherall and fellow editors of the Oxford Textbook of Medicine rally (July 1, p 4) to rebut the charge that medical textbooks as a genus may soon face extinction. Apparently someone in the House of Lords had cited a passage in the 1987 edition that questioned the use of thrombolytic therapy for acute myocardial infarction. I used to refer to that edition regularly. I found it easy to read and, since I work in the developing world, the 847
Drugs and mental health SIR-MIND (National Association for Mental Health) appreciated your Aug 5 editorial. It is encouraging to read such a balanced piece. The debate on medication will no doubt continue, and, since MIND’s position is sometimes misrepresented, I thought I would describe it. MIND does recognise that medication can be helpful but is concerned that the adverse effects are often underestimated by those who do not experience them. Our research shows that over 60% of people taking neuroleptic drugs experience severe or very severe adverse effects. Patients were dissatisfied with the information they were given. 80% felt that they had not been told enough about their treatment generally, and 70% were dissatisfied with the amount of information on the side-effects of drugs. MIND receives many calls to its information service from people who are worried about their medication-for instance, because they have been told very little about it, or are experiencing adverse effects. We are concerned about some of the apparently poor prescribing practice which comes to light in the course of these enquiries-for example people being taken off neuroleptics or benzodiazepines abruptly, or being prescribed more than one neuroleptic drug at a time, or being put on depot medication for years without review. Although the Royal College of Psychiatrists has warned about the use of high doses of neuroleptics (and MIND welcomes this), the use of high doses seems to have become too common for that statement to be enough to stop the practice. Through our publications and information service we aim to provide full information about psychiatric drugs. One initiative, which has the support of the Committee on Safety of Medicines (CSM), is MIND’s own "yellow card scheme". This is a way for people to report suspected adverse drug reactions to the CSM via MIND. Judi Clements MIND, Granta House, 15/19 Broadway, London E15 4BQ, UK
Celebrity illness SIR-You are right in your Aug 26 editorial to focus on the issue of how the name of a patient with a particular disease enters the public domain. As a press officer who has worked within the National Health Service for 14 years I have repeatedly faced this difficulty, which is not easy. However, you mention the "well-known UK medical scientist who recently underwent treatment by a famous’ surgeon" and refer to "the spin" being "handled by the scientist’s researchfund administrator and the press office of the hospital where the patient is being treated". I run the press office at the hospital to which you refer, and note that you define the word spin as "manipulation put on a case for purposes other than the wellbeing of the patient". In this case it was the patient herself who sought the publicity, and for a disinterested motive-publicity for fundraising for the condition from which she was suffering. Many patients come forward of their own accord to help hospitals raise funds and
I cannot see any sinister behind this.
motive-your
"darker side"-
attract the interest of the work with deal with such enquiries fairly and openly, while always protecting their patients from unwelcome interest. There have been several occasions when the parents of sick children on the transplant waiting list have sought publicity, through a public appeal for a heart. That has to be their decision, but where possible we talk through with them both the downside of media attention, and the fact that relatives of other very sick children may not be happy to see one particular case hit the headlines. We never encourage such appeals, but where the family is determined to make use of media interest in this way we do our best to support them. Everyone would agree with you that more publicity should have been given to the Transplant Olympic Games.. But such publicity would clearly have named the participants. My colleagues and I always "reiterate the presumption of confidentiality in favour of the patient". But patients are also grown-up human beings who understand and sometimes even welcome press coverage.
Specialist hospitals frequently
media, and those
we
Jonathan Street Jonathan Street Public Relations Limited, London W2
Siena and
3QR, UK
operation Michelangelo
SIR-It is surprising that such scientific journal should spread intends to
an
an
important international unfounded
rumour
that
scandal, by publishing (Aug 5, clearly p 366) news on two wholly unconnected events-namely, plans for new units at Siena’s University Hospital and a police investigation into allegations of corruption elsewhere in Tuscany. create
Simini should have been more accurate and made it clear that the new units in Siena are a matter of internal organisation within the Azienda Ospedaliera di Siena and concern
highly specialised departments.
Simini mentions ophthalmology. This department has a world wide reputation and was recently asked by Italy’s prime minister to help a Bosnian child. Simini also mentions infertility; Siena’s CNR research unit on sterility in men is the only one in Italy. The other organisational principle is teaching requirements. It is not a question of creating new primariati (clinical departmental heads) but of looking at our responsibilities to patients. The Azienda Ospedaliera will not be charged unless it is demonstrated that there is a fair balance between costs and benefits over a three-year pilot
period. In replying to Simini’s letter my sole concern is that the truth is respected and the dignity of the Faculty of Medicine of the University of Siena is maintained. Piero Tosi Office of the Rector, Universitá 53100 Siena, Italy
degli Studi di Siena, Banchi di Sotto 55,
Out-of-date textbooks SiR-Weatherall and fellow editors of the Oxford Textbook of Medicine rally (July 1, p 4) to rebut the charge that medical textbooks as a genus may soon face extinction. Apparently someone in the House of Lords had cited a passage in the 1987 edition that questioned the use of thrombolytic therapy for acute myocardial infarction. I used to refer to that edition regularly. I found it easy to read and, since I work in the developing world, the 847