BMJ  2004;329:179 (17 July), doi:10.1136/bmj.329.7458.179

reviews

PERSONAL VIEW

Resisting cookbook medicine

The first 150 words of the full text of this article appear below.

"It is now the standard of care that every postmenopausal woman be given replacement hormones for the rest of her life unless there is a medical reason not to; to practise otherwise may be considered malpractice." These words, passionately spoken at a 2001 medical education conference by a foremost authority on women's health, left some listeners feeling uneasy. Unable to find randomised controlled trials that validated the presumed benefits of long term hormone replacement therapy (HRT), we concluded that HRT for disease prevention represented an experiment on women.

Today, two years after the release of the results of the women's health initiative study showing that HRT has more potential for harm than for good in healthy postmenopausal women taking a combination of oestrogen and progestogen to prevent chronic disease, the questions of 2001 remain relevant. Do individual doctors have the freedom to critically analyse available evidence and make management decisions . . . [Full text of this article]

University of Alberta, Canada sgenuis@ualberta.ca

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This article has been cited by other articles:

• Genuis, S J (2006). Dismembering the ethical physician.. Postgrad. Med. J. 82: 233-238 [Abstract] [Full text]  
• Reilly, B. M., Evans, A. T. (2006). Translating Clinical Research into Clinical Practice: Impact of Using Prediction Rules To Make Decisions. ANN INTERN MED 144: 201-209 [Abstract] [Full text]  

Rapid Responses:

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Doctors or patients?

Peter Celec
bmj.com, 20 Aug 2004 [Full text]