David Nutt, Off-Duty Doctors and Aspirin Prescribing

Wanted to write something about the news of the dismissal of David Nutt, the chair of the government's Advsiory Council on the Misuse of Drugs. He was sacked by the home secretary, Alan Johnson, causing a rift between scientists and the government. It seems like there have been more than one case in recent years when advice to the government has been ignored if deemed an 'inconvenient truth'. I certainly don't agree that he should have lost his job over such an incident, it seems counter-productive to me. The reason he was sacked was due to comments he made about cannabis which contradicted current legislation, saying these didn't reflect clinical evidence. It's interesting that one of his points was that alcohol and tobacco are probably more dangerous than LSD and certain other illicit drugs. I think it's probably true that alcohol and tobacco bear a far greater public health burden than the illicit drugs but it would be dangerous for the public to have a perception that illegal drugs were infact more safe than previously thought. Article avaliable at http://news.bbc.co.uk/1/hi/health/8343004.stm

I read an interesting article about whether doctors off-duty should offer advice to strangers, the example given about an endocrologist telling a woman on a bus to go and have tests having spotted signs of acromegaly. In a clinical setting a patient sees a doctor consenting to be told information about their health, so is it un-ethical to confront someone like this? On the other hand as doctors with greater knowledge, do we have a moral responsibility to point out these things? What if the doctor was wrong? Intervention could cause un-necessary stress and anxiety to the patient. I thought this raised quite a lot of interesting ethical points.
http://www.guardian.co.uk/lifeandstyle/2009/nov/03/doctor-diagnosis-stranger

BMJ Blog 6th November 2009: Prescribing of aspirin - should it be prescribed as a primary preventative? A meta-analysis review of literature has concluded that use in people without cardiovascular disease should not be carried out, in any group of patients. Of course it has huge benefits for patients with cardiovascular disease, eg recently suffered a stroke. Some clinical practice guidelines do still recommend use of aspirin. Risks of taking aspirin largely offset the limited benefits. People who have been taking aspirin for many years need not suddenly stop taking aspirin but should have a discussion with their GP about their use of the drug.
Aspirin for primary prevention of vascular disease in people with diabetes. Published 6 November 2009, BMJ 2009;339:b4596