Life and Style General view of Solihull Hospital, West Midlands where the now-suspended surgeon operated

The procedure leaves some breast tissue behind and is not recognised by national guidelines, because of the greater risk of cancer recurring

GOING DOWN: Smiths Industries

SHARES of Smiths Industries fell 15 per cent, on disappointment that first-half profit growth came only from its aerospace business. This grew by 42 per cent, but the other two businesses, which produce ventilation and other industrial equipment and hospital supplies, saw little growth.



Right of Reply: Michael Wilks

The chairman of the BMA's ethics committee replies to an article calling for compulsory organ donation

Letter: No `collapse'

Sir: Whilst I hope to be able to comment, in due course, and following publication of the Stephen Lawrence Inquiry Report, on the issues arising from this tragic case, might I take this opportunity to correct a minor, but irritating, error in the reporting of my evidence to the Inquiry.

Health: Is your therapist a friend?

A good counsellor offers many of the qualities you might look for in a friendship. By Paul Gordon

Letter: Fighting CJD

Sir: Medical experts are considering scrapping surgical instruments after each contact with a CJD-carrying tissue, including possibly tonsils. While conventional sterilisation techniques, using overheated steam, are obviously ineffective in killing off the prions, which survive up to 360C, electrothermal appliances would probably offer a satisfactory solution while not melting the instruments - an induction annealing furnace, or an industrial microwave oven.

Leading Article: The reality of rationing in the health service

PARLIAMENTARY DEBATES, such as yesterday's on the NHS, are all very well: but they will have little impact so long as Honourable Members seem to inhabit a different world from the rest of us.

Letter: Healing the NHS

Sir: Your article "Undercover monitors to check on GPs" (4 January) is misleading. In November 1998, the General Medical Council decided that specialists and general practitioners must be able to demonstrate - on a regular basis - that they are keeping themselves up to date and remain fit to practise in their chosen field. A steering group has been set up to carry out further work in preparation for further discussion, on the implementation issues, in February.

Letter: You can't go your own way

THE ARTICLE by Julia Sinclair is a sad tale of poorly managed terminal care, but it contributes nothing to any argument for euthanasia. The fact that we feel helpless in the face of impending death is not sufficient reason to kill the patient. Living wills allow patients to state in advance the kind of treatments they do not want, but they do not allow us to demand that health-care staff take someone's life. From Ms Sinclair's description it sounds as if the poor young locum doctor finally gave her father an adequate dose of analgesia, but it was clearly not a lethal injection in the sense demanded by supporters of euthanasia. Following a lethal injection the patient does not regain consciousness next morning and smile at his loved ones.

Words: aboulia, n.

OUTSIDE THE changing-rooms at the London Library, the 18th-century scholar Keith Walker replied to my enquiry after his health, "I'm suffering from aboulia today."

Letter: Patients' rights

Sir: Jeremy Laurance's report (16 November) on Rodney Ledward's surgical record must have sent a chill down the spine of any woman who has ever consulted a gynaecologist. Elsewhere in the report was another chilling aspect: Brenda Johnson, after suffering an unnecessary and incompetent hysterectomy by Mr Ledward, begged her GP to refer her to another specialist. He refused, saying it was "unethical".

Letter: Transfusion errors

Transfusion errors

Back experts only of 'marginal benefit'

CHIROPRACTIC, one of the best established alternative treatments for back pain, is of marginal benefit and it is probably not worth the cost, according to a new study.

Letter: Surgical chore

Sir: Circumcision would appear to be pointless.

Treatment for ME costing pounds 1bn a year

CHRONIC FATIGUE syndrome is costing the country at least pounds 1bn a year in medical costs for sufferers, welfare benefits and other payments yet little is being done to treat it, according to a report.
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