Obstetrician and gynaecologist Rupert Fawdry was an original thinker, dismissed by some as a Luddite and acclaimed by others as a maverick genius. If computers had been invented first, he suggested, paper and pen might have been considered the greatest IT breakthrough since the dawn of civilisation. This may seem an odd and even illogical observation by a charming eccentric who had an “affair” with the computer, according to his Canadian born first wife Judy. This passionate, obsessive affair reflected a love of structure and an overwhelming desire to organise the world—in particular, medical records. Fawdry highlighted dozens of inconsistencies in some 70 maternity datasets. The Körner model, for example, lacked an option for a breech birth by caesarean, he said, while the “place of birth” option seemed to differ in each dataset. Perhaps it was the depth of his knowledge and experience that ultimately made him appreciate the limitations of computerised medical records in obstetrics and care of the elderly. He was, despite boundless zeal, a pragmatist. He told a parliamentary committee in 2003: “Sadly, time and again, I have found myself helplessly watching the almost …
{"title":"Rupert Fawdry: obstetrician whose fascination with computerised medical records soon turned to disappointment","authors":"John Illman","doi":"10.1136/bmj.r24","DOIUrl":"https://doi.org/10.1136/bmj.r24","url":null,"abstract":"Obstetrician and gynaecologist Rupert Fawdry was an original thinker, dismissed by some as a Luddite and acclaimed by others as a maverick genius. If computers had been invented first, he suggested, paper and pen might have been considered the greatest IT breakthrough since the dawn of civilisation. This may seem an odd and even illogical observation by a charming eccentric who had an “affair” with the computer, according to his Canadian born first wife Judy. This passionate, obsessive affair reflected a love of structure and an overwhelming desire to organise the world—in particular, medical records. Fawdry highlighted dozens of inconsistencies in some 70 maternity datasets. The Körner model, for example, lacked an option for a breech birth by caesarean, he said, while the “place of birth” option seemed to differ in each dataset. Perhaps it was the depth of his knowledge and experience that ultimately made him appreciate the limitations of computerised medical records in obstetrics and care of the elderly. He was, despite boundless zeal, a pragmatist. He told a parliamentary committee in 2003: “Sadly, time and again, I have found myself helplessly watching the almost …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142968224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
It can be hard to know how to respond when asked to undertake a task that isn’t part of your role, but there are ways to deal with it, Abi Rimmer hears Ashley Simpson, medical education fellow, NHS Lothian, says, “Being asked to undertake a task you believe is outside your role can be challenging. Navigating these situations is often context dependent, requiring a balance between your professional responsibilities, team working, and patient safety. “Delivering healthcare is a team effort, with each professional holding specific responsibilities. There is often overlap in competencies, however, meaning that some tasks can be undertaken by multiple team members. “As a resident doctor rotating though departments, it’s important to clarify the typical responsibilities of team members in each setting. A task outside your role in one department may fall within it in another. Establishing role boundaries can empower you to handle situations like this more effectively. “Occasionally you may be asked to complete tasks typically assigned to others—for example, phlebotomy—because of workload or staffing pressures. In these instances, working collaboratively may be the best approach for patient care. If this becomes a frequent occurrence, impacting your own clinical responsibilities or professional development, you should escalate this to your clinical or educational supervisor. “The General Medical Council requires doctors to work within their competence. If you are asked to perform a task that you are not trained to undertake, you must voice this. While that might feel difficult in hierarchical teams, patient safety is your priority. Politely explain—for example, ‘I’m sorry, I’m not competent to perform this task safely. I think it …
{"title":"I’ve been asked to do something that falls outside my role, what should I do?","authors":"Abi Rimmer","doi":"10.1136/bmj.q2869","DOIUrl":"https://doi.org/10.1136/bmj.q2869","url":null,"abstract":"It can be hard to know how to respond when asked to undertake a task that isn’t part of your role, but there are ways to deal with it, Abi Rimmer hears Ashley Simpson, medical education fellow, NHS Lothian, says, “Being asked to undertake a task you believe is outside your role can be challenging. Navigating these situations is often context dependent, requiring a balance between your professional responsibilities, team working, and patient safety. “Delivering healthcare is a team effort, with each professional holding specific responsibilities. There is often overlap in competencies, however, meaning that some tasks can be undertaken by multiple team members. “As a resident doctor rotating though departments, it’s important to clarify the typical responsibilities of team members in each setting. A task outside your role in one department may fall within it in another. Establishing role boundaries can empower you to handle situations like this more effectively. “Occasionally you may be asked to complete tasks typically assigned to others—for example, phlebotomy—because of workload or staffing pressures. In these instances, working collaboratively may be the best approach for patient care. If this becomes a frequent occurrence, impacting your own clinical responsibilities or professional development, you should escalate this to your clinical or educational supervisor. “The General Medical Council requires doctors to work within their competence. If you are asked to perform a task that you are not trained to undertake, you must voice this. While that might feel difficult in hierarchical teams, patient safety is your priority. Politely explain—for example, ‘I’m sorry, I’m not competent to perform this task safely. I think it …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142968221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
An energy crisis has seen regular power blackouts throughout South America. Andersson Boscán reports from Ecuador where the situation is costing lives in both hospitals and homes Gabriela Alvaro’s blood was flowing through a dialysis machine when the power in Ecuador went out nationwide. “Generators can take up to a minute and a half to start,” says Alvaro, 31, whose kidneys stopped functioning eight years ago. She relies on dialysis three times a week. “That minute and a half felt eternal. I remember being afraid that my blood would clot and they wouldn’t be able to return it to my body. That would kill me, of course. I don’t remember much else—I fainted.” It was 5 August 2024, and the latest in a series of scheduled blackouts that left the country in darkness for at least 70 days, with some outages lasting 14 hours. Every Friday the government announces the power outages scheduled for the following week. Life is planned around the affected areas and times. By government mandate, public healthcare facilities are exempt from power cuts, although private hospitals are left to keep running on their own. The Ecuadorian Ministry of Public Health told The BMJ , “Patient care is guaranteed, especially in critical areas such as intensive care units and emergency rooms. Additionally, the safety of patients and the continuity of essential services like …
{"title":"Blackout deaths: the grim toll of Ecuador’s energy crisis","authors":"Andersson Boscán, freelance journalist","doi":"10.1136/bmj.r32","DOIUrl":"https://doi.org/10.1136/bmj.r32","url":null,"abstract":"An energy crisis has seen regular power blackouts throughout South America. Andersson Boscán reports from Ecuador where the situation is costing lives in both hospitals and homes Gabriela Alvaro’s blood was flowing through a dialysis machine when the power in Ecuador went out nationwide. “Generators can take up to a minute and a half to start,” says Alvaro, 31, whose kidneys stopped functioning eight years ago. She relies on dialysis three times a week. “That minute and a half felt eternal. I remember being afraid that my blood would clot and they wouldn’t be able to return it to my body. That would kill me, of course. I don’t remember much else—I fainted.” It was 5 August 2024, and the latest in a series of scheduled blackouts that left the country in darkness for at least 70 days, with some outages lasting 14 hours. Every Friday the government announces the power outages scheduled for the following week. Life is planned around the affected areas and times. By government mandate, public healthcare facilities are exempt from power cuts, although private hospitals are left to keep running on their own. The Ecuadorian Ministry of Public Health told The BMJ , “Patient care is guaranteed, especially in critical areas such as intensive care units and emergency rooms. Additionally, the safety of patients and the continuity of essential services like …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142968219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The covid-19 pandemic and the recent cost-of-living crisis have substantially exacerbated pre-existing inequalities in health and social care in the UK.1 Marginalised populations are disproportionately affected, for example by experiencing higher rates of childhood obesity, depression, and maternal and neonatal mortality.2 Paradoxically, those who are most in need of medical care—disadvantaged populations—often face the greatest barriers to accessing it. In England, people living in the most deprived areas are twice as likely to wait over a year for non-urgent treatment compared to others.3 For the NHS to make a real difference to health equity, local organisations should not be waiting for a solution to emerge nationally. Instead, they should be looking to, and working with, the local populations they serve. For instance, there is a critical need for better data on …
{"title":"We need to focus on local solutions for health inequalities","authors":"Ara Darzi, Tetiana Lunova, Peter Howitt","doi":"10.1136/bmj.r55","DOIUrl":"https://doi.org/10.1136/bmj.r55","url":null,"abstract":"The covid-19 pandemic and the recent cost-of-living crisis have substantially exacerbated pre-existing inequalities in health and social care in the UK.1 Marginalised populations are disproportionately affected, for example by experiencing higher rates of childhood obesity, depression, and maternal and neonatal mortality.2 Paradoxically, those who are most in need of medical care—disadvantaged populations—often face the greatest barriers to accessing it. In England, people living in the most deprived areas are twice as likely to wait over a year for non-urgent treatment compared to others.3 For the NHS to make a real difference to health equity, local organisations should not be waiting for a solution to emerge nationally. Instead, they should be looking to, and working with, the local populations they serve. For instance, there is a critical need for better data on …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
My list of 110 medically related anniversaries for 2025 (events in years ending ’25 and’75) includes: ● Fifty two births: Charles Rochemont Aikin, surgeon; William Aitken, pathologist; Sir John Baber, physician; Helen Rae Bamber née Balmuth, human rights advocate and psychotherapist; Charles Cassidy Bass, American physician; Norman Bier, optometrist and contact lens specialist; Baruch Samuel “Barry” Blumberg, American scientist; Henry Edmund Gaskin Boyle, anaesthetist; Leslie Baruch Brent, transplantation immunologist; Fred Brown, virologist; Alfred John Carpenter, physician; Jean-Martin Charcot, French physician and neurologist; Joseph Thomas Clover, anaesthetist and surgeon; Barry Albert Cross, physiologist; Henry Hallett Dale, pharmacologist and physiologist; William Bill Davison, geriatrician; John Dossetor, Canadian physician; Robert Geoffrey Edwards, physiologist; John Richard Farre, physician; Robert Jackson Fletcher, optometrist; Paul Greengard, American neuroscientist; Wendy Elsa Greengross, general practitioner and broadcaster; David Gregorie, Scottish physician; Samuel Osborne Habershon, physician; Daniel Hanbury, pharmacologist; Henry Harris, cell biologist; Andrew Herxheimer, physician and clinical pharmacologist; Henry Tristram Holland, missionary and eye surgeon; Timothy Holmes, surgeon; Thomas Henry Huxley, biologist; John Kidd, physician; Homer Terril Lane, educationist and psychoanalyst; John Charles Grant Ledingham, bacteriologist; Mary Frances Lyon, geneticist; Johann Baptist Malfatti, Count of Monteregio, Italian born physician; John Marks, chairman of the BMA; Thomas Morson, pharmaceutical manufacturer; Autar Singh Paintal, Indian scientist, discoverer of sensory receptors; Edward William Pritchard, surgeon and poisoner; Reginald Crundall Punnett, experimental geneticist; Richard Reece, physician; J Murdoch Ritchie, neuroscientist, biophysicist, and pharmacologist; William Tindal Robertson, physician; Martin Rodbell, American scientist; Oliver Smithies, biochemist and geneticist; Henry Sessions Souttar, surgeon; Keith Sykes, professor of clinical anaesthesia; Alexander Cuthbert Turnbull, professor of obstetrics and gynaecology; Hubert Maitland Turnbull, pathologist; Patrick David Pat Wall, neuroscientist; John Wood, surgeon; Oliver Murray Wrong, physician and nephrologist; ● Twenty four deaths: Charles Cassidy Bass, American physician; Thomas Bowdler, English physician and expurgator; George Calvert, surgeon; Colin Chisholm, …
{"title":"When I use a word . . . Medical anniversaries in 2025","authors":"Jeffrey K Aronson","doi":"10.1136/bmj.r61","DOIUrl":"https://doi.org/10.1136/bmj.r61","url":null,"abstract":"My list of 110 medically related anniversaries for 2025 (events in years ending ’25 and’75) includes: ● Fifty two births: Charles Rochemont Aikin, surgeon; William Aitken, pathologist; Sir John Baber, physician; Helen Rae Bamber née Balmuth, human rights advocate and psychotherapist; Charles Cassidy Bass, American physician; Norman Bier, optometrist and contact lens specialist; Baruch Samuel “Barry” Blumberg, American scientist; Henry Edmund Gaskin Boyle, anaesthetist; Leslie Baruch Brent, transplantation immunologist; Fred Brown, virologist; Alfred John Carpenter, physician; Jean-Martin Charcot, French physician and neurologist; Joseph Thomas Clover, anaesthetist and surgeon; Barry Albert Cross, physiologist; Henry Hallett Dale, pharmacologist and physiologist; William Bill Davison, geriatrician; John Dossetor, Canadian physician; Robert Geoffrey Edwards, physiologist; John Richard Farre, physician; Robert Jackson Fletcher, optometrist; Paul Greengard, American neuroscientist; Wendy Elsa Greengross, general practitioner and broadcaster; David Gregorie, Scottish physician; Samuel Osborne Habershon, physician; Daniel Hanbury, pharmacologist; Henry Harris, cell biologist; Andrew Herxheimer, physician and clinical pharmacologist; Henry Tristram Holland, missionary and eye surgeon; Timothy Holmes, surgeon; Thomas Henry Huxley, biologist; John Kidd, physician; Homer Terril Lane, educationist and psychoanalyst; John Charles Grant Ledingham, bacteriologist; Mary Frances Lyon, geneticist; Johann Baptist Malfatti, Count of Monteregio, Italian born physician; John Marks, chairman of the BMA; Thomas Morson, pharmaceutical manufacturer; Autar Singh Paintal, Indian scientist, discoverer of sensory receptors; Edward William Pritchard, surgeon and poisoner; Reginald Crundall Punnett, experimental geneticist; Richard Reece, physician; J Murdoch Ritchie, neuroscientist, biophysicist, and pharmacologist; William Tindal Robertson, physician; Martin Rodbell, American scientist; Oliver Smithies, biochemist and geneticist; Henry Sessions Souttar, surgeon; Keith Sykes, professor of clinical anaesthesia; Alexander Cuthbert Turnbull, professor of obstetrics and gynaecology; Hubert Maitland Turnbull, pathologist; Patrick David Pat Wall, neuroscientist; John Wood, surgeon; Oliver Murray Wrong, physician and nephrologist; ● Twenty four deaths: Charles Cassidy Bass, American physician; Thomas Bowdler, English physician and expurgator; George Calvert, surgeon; Colin Chisholm, …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charles and colleagues’ overview of management of acute pain crisis in sickle cell disease is welcome,1 especially as patients move away from city centres to areas that typically have a less ethnically diverse demographic. As a consultant haematologist specialising …
{"title":"Acute painful crisis in sickle cell disease: transfusion is not a benign treatment","authors":"Sonia N Wolf","doi":"10.1136/bmj.r37","DOIUrl":"https://doi.org/10.1136/bmj.r37","url":null,"abstract":"Charles and colleagues’ overview of management of acute pain crisis in sickle cell disease is welcome,1 especially as patients move away from city centres to areas that typically have a less ethnically diverse demographic. As a consultant haematologist specialising …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I agree with Wolf’s concerns about transfusion in sickle cell disease.12 In developed countries, where the blood donor pool is predominantly white and lacking the Ro antigen, transfusion for sickle cell disease is often affected by alloantibody formation, which complicates future transfusions. Iron overload is a potential complication of chronic blood transfusions in …
{"title":"Author’s reply to Wolf","authors":"Kenneth S Charles","doi":"10.1136/bmj.r45","DOIUrl":"https://doi.org/10.1136/bmj.r45","url":null,"abstract":"I agree with Wolf’s concerns about transfusion in sickle cell disease.12 In developed countries, where the blood donor pool is predominantly white and lacking the Ro antigen, transfusion for sickle cell disease is often affected by alloantibody formation, which complicates future transfusions. Iron overload is a potential complication of chronic blood transfusions in …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle Fernandez, Luísa M M Fernandes, Melania M R de Amorim
The proposed constitutional amendment would be a massive setback for reproductive rights and health in Brazil, write Michelle Fernandez , Luísa Fernandes , and Melania de Amorim In Brazil, a proposed constitutional amendment is currently being discussed in the National Congress, aiming to criminalise abortion in the country entirely.1 It stipulates prison sentences for women who undergo the procedure, ranging from 6 to 20 years, regardless of the circumstances. The proposal equates abortion with the crime of homicide. The suggested penalties for abortion are harsher than those currently imposed on rapists, who face a maximum of 10 years in prison. The proposed amendment would threaten the reproductive rights and health of women in Brazil, and directly affect their dignity and autonomy. Abortion remains illegal in Brazil except in three specific circumstances: pregnancies resulting from rape, cases where the woman’s life is at …
{"title":"Total criminalisation of abortion is a threat to sexual and reproductive health in Brazil","authors":"Michelle Fernandez, Luísa M M Fernandes, Melania M R de Amorim","doi":"10.1136/bmj.r52","DOIUrl":"https://doi.org/10.1136/bmj.r52","url":null,"abstract":"The proposed constitutional amendment would be a massive setback for reproductive rights and health in Brazil, write Michelle Fernandez , Luísa Fernandes , and Melania de Amorim In Brazil, a proposed constitutional amendment is currently being discussed in the National Congress, aiming to criminalise abortion in the country entirely.1 It stipulates prison sentences for women who undergo the procedure, ranging from 6 to 20 years, regardless of the circumstances. The proposal equates abortion with the crime of homicide. The suggested penalties for abortion are harsher than those currently imposed on rapists, who face a maximum of 10 years in prison. The proposed amendment would threaten the reproductive rights and health of women in Brazil, and directly affect their dignity and autonomy. Abortion remains illegal in Brazil except in three specific circumstances: pregnancies resulting from rape, cases where the woman’s life is at …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142961717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
“Eco-anxiety” is growing worldwide, especially among young people.1 Considerable anxiety about the climate crisis is rational, particularly for young people, for whom even 2100 is a tangible date. Deep concern for future human and ecological wellbeing is justified among all ages, not only because of the disturbing evidence of climate breakdown, but also because of the apparent climate change policy paralysis, especially in so-called developed countries—the global North. Climate policy paralysis and hypocrisy are stark given the disturbing evidence of rising global temperatures in the last 18 months. The primary responsibility for climate change lies with the lifestyles and intransigence of the world’s most affluent people, most of whom live in high-income nations including Europe, the US, Canada, and Australia. Although these populations have, to date, been comparatively insulated from the harm caused by climate change, more extreme climate related weather events are becoming increasingly frequent, such as wildfires in Canada, or recent flooding in Europe. Both enlightened self-interest and activism are needed to awaken transformative action on the climate. #### Climate change: a global emergency The potential for climate change to undermine prosperity and development in so-called developing countries—the global South—has been recognised by advocates for decades.23 There is accumulating evidence that these warnings are not fear-mongering, and indeed may be too optimistic.4 Despite this, most governments in the global North act as though there is …
{"title":"What “dose” of anxiety is needed to awaken transformative action on climate change?","authors":"Colin D. Butler, Mala Rao","doi":"10.1136/bmj.q2584","DOIUrl":"https://doi.org/10.1136/bmj.q2584","url":null,"abstract":"“Eco-anxiety” is growing worldwide, especially among young people.1 Considerable anxiety about the climate crisis is rational, particularly for young people, for whom even 2100 is a tangible date. Deep concern for future human and ecological wellbeing is justified among all ages, not only because of the disturbing evidence of climate breakdown, but also because of the apparent climate change policy paralysis, especially in so-called developed countries—the global North. Climate policy paralysis and hypocrisy are stark given the disturbing evidence of rising global temperatures in the last 18 months. The primary responsibility for climate change lies with the lifestyles and intransigence of the world’s most affluent people, most of whom live in high-income nations including Europe, the US, Canada, and Australia. Although these populations have, to date, been comparatively insulated from the harm caused by climate change, more extreme climate related weather events are becoming increasingly frequent, such as wildfires in Canada, or recent flooding in Europe. Both enlightened self-interest and activism are needed to awaken transformative action on the climate. #### Climate change: a global emergency The potential for climate change to undermine prosperity and development in so-called developing countries—the global South—has been recognised by advocates for decades.23 There is accumulating evidence that these warnings are not fear-mongering, and indeed may be too optimistic.4 Despite this, most governments in the global North act as though there is …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A new year is meant to bring new hope, and perhaps this one does too, but it’s hard to be thrilled by health services overwhelmed by winter pressures (doi:10.1136/bmj.q2871),1 transatlantic rabble rousing, and insoluble global crises and conflicts. What a new year can certainly bring is a fresh start, with new energy and effort to direct ourselves away from a destructive future, to focus on improving people’s health and wellbeing. Yet with each era the task grows more complex. In Samuel Taylor Coleridge’s Rime of the Ancient Mariner , sailors marooned on a ship drifting near the equator are tortured by “water, water, every where, nor any drop to drink.” Medicine at that time, the end of the 18th century, was …
{"title":"Paradoxes, fresh starts, and the fortnightly BMJ","authors":"Kamran Abbasi","doi":"10.1136/bmj.r31","DOIUrl":"https://doi.org/10.1136/bmj.r31","url":null,"abstract":"A new year is meant to bring new hope, and perhaps this one does too, but it’s hard to be thrilled by health services overwhelmed by winter pressures (doi:10.1136/bmj.q2871),1 transatlantic rabble rousing, and insoluble global crises and conflicts. What a new year can certainly bring is a fresh start, with new energy and effort to direct ourselves away from a destructive future, to focus on improving people’s health and wellbeing. Yet with each era the task grows more complex. In Samuel Taylor Coleridge’s Rime of the Ancient Mariner , sailors marooned on a ship drifting near the equator are tortured by “water, water, every where, nor any drop to drink.” Medicine at that time, the end of the 18th century, was …","PeriodicalId":22388,"journal":{"name":"The BMJ","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142936643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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