Singh & the BCA

But most damnable is that this case should have taken place in the arena of medicine, where reasonable criticism of each others practises should never be stifled, for one very simple reason: it’s possible, in medicine, to do enormous harm, even when you set out with the best of intentions.

Anti-arrhythmic drugs provide a chllling example. For a few years in the 1980s these were prescribed to everyone who had a heart attack. It made absolute sense in theory: people who’ve had heart attacks often get abnormal heart rhythms, these irregular rhythms can often finish you off, but anti-arrhythmic drugs prevent them. Why not just give these anti-arrhythmic drugs to everyone who has had a heart attack, on the off chance? They were safe and effective when given to people who had abnormal rhythms, after all. But when prescribed preventively, to everyone, after a heart attack, they turned out to increase your risk of dying, and because so many people had them – because so many people have heart attacks – the deaths were on a biblical scale, killing as many Americans as died in the whole of the Vietnam war, before anyone had a chance to notice that something was wrong.

Ben Goldacre on Simon Singh's victory in the libel suit by the British Chiropractic Association, the rest here.