BMA releases doctors’ guide to medical ethics dilemmas

Extract from NHS Networks

Such dilemmas could include whether serious but unproven allegations of patients’ violence and abuse should be recorded in their medical notes, or whether doctor should tell people if their partners are HIV positive.

Everyday Medical Ethics and Law, extracts the practical advice on everyday ethical dilemmas found in the BMA’s more extensive ethics handbook, and presents it as a reference guide in paperback format.

It summarises best-practice standards, legal benchmarks and advice from expert organisations on areas such as the doctor-patient relationship, consent, capacity, confidentiality and the management of health records.

Best Practice App – all clear

There is a new release of the Best Practice app available on iTunes. The technical issues with the display of some treatment options in the previous version, which caused us to temporarily withdraw the app, have been resolved and all users should update to the new release at the earliest opportunity.

As a previous user the new release should be available to you as an update and free of charge. If you have any problems please contact our Customer Services team at

RECALL of Best Practice app – URGENT

mphoneMessage from BMJ

We have been experiencing a technical fault with the Best Practice app for iPad. 

Please delete the Best Practice app for iPad and for iPhone from your systems and from any shared devices.  We are trying to reach all users but you may have more up to date user data so we would request that you take the necessary steps to inform your users that they should not use the app.

We are confident that this technical fault only applies to the iPad app but we have also temporarily withdrawn the app for iPhone as a precaution until an app update for both iPad and iPhone is available.

We are taking urgent steps to correct the fault and to issue an updated app.  Our customer services team will be in touch as soon as the revised app for iPad and iPhone are available – having previously downloaded the app you will be able to download the updated versions free of charge.

Please note that Best Practice on other platforms such as the online version ( and the mobile browser version ( are not affected by this fault and we therefore recommend that your users access these in the meantime.

We apologise for the inconvenience caused by this fault and ask that you take the actions above without delay.

BMJ Best Practice update

Best Practice will soon include a new symptom search feature  to provide a list of differential diagnoses based on a patient’s presenting symptoms, age and gender.  Search results will link you directly to the relevant condition in Best Practice – helping you to consider a wider range of differentials as part of the patient consultation process.

Due out in June, the search box will appear at the top of every Best Practice screen.

Featured updated topic: Renal artery stenosis

Renal artery stenosis is typically due to atherosclerotic disease or fibromuscular dysplasia. It often presents with accelerated or difficult-to-control hypertension. Worsening kidney function, especially after initiation of renin-angiotensin blockade, and recurrent flash pulmonary oedema are common features. Renal artery stenosis, renovascular hypertension, and ischaemic nephropathy are various manifestations of this process. Definitive diagnosis is with imaging. Patients may already be receiving treatment with multiple antihypertensive medications; therapy of this disorder includes additions to and adjustments of antihypertensive agents in order to achieve target control of blood pressure.  Secondary prevention measures such as aspirin, a statin, or smoking cessation may be required. This topic also discusses the role of non-medical therapy (e.g., percutaneous intervention) for renal artery stenosis.  “

BMJ: Best Practice looks at Diabetes insipidus

Featured updated topic: Diabetes insipidus

Diabetes insipidus is characterised by polydipsia, polyuria, increased thirst, and formation of hypotonic urine. Two types exist: central DI, due to defective synthesis or release of arginine vasopressin (AVP) from the hypothalamo-pituitary axis; and nephrogenic DI, due to renal insensitivity to AVP. Both types of DI may be associated with hypernatremia, and this may present as a medical emergency. Treatment goals are correction of any pre-existing water deficits and reduction in ongoing excessive urinary water losses. In central DI, desmopressin is the treatment of choice. Nephrogenic DI is treated with an adequate fluid intake; salt restriction and diuretics may help reduce polyuria.

Read the full article here

Clinical Evidence systematic reviews inside Best Practice

For a full list of updated topics, please visit our website.

The Clinical Evidence systematic reviews are now available for you to access within Best Practice. The content of Best Practice is also linked to the appropriate Clinical Evidence systematic review via evidence scores. Below are some of the Clinical Evidence reviews that have been updated over the past few months:

Atrial fibrillation (chronic) New evidence found

Kidney stones  New evidence found