It is simple enough to declare that the acceptability of drug advertising and promotion must be assessed in the light of the true facts. However, the quest for a definition of what constitutes truth is at least as frustrating where most medicines are concerned as in any other field. As noted in Chapter 1, even the picture of a drug’s safety and efficacy that is drawn by a committee of experts at the moment that it is licensed is only a provisional sketch that will necessarily be supplemented by experience in the field as time – sometimes a long time – goes by. Acetylsalicylic acid (Aspirin) was used without reservation to treat feverish infants from the time of the drug’s introduction in 1899 until, many decades later, a causal link between such treatment and the serious complication known as Reye’s syndrome was suspected and later confirmed (Section 1.7). More than 40 years on, even that intensively studied link remains an indistinct and irregular one, perhaps involving some genetic predisposition; the debate on selecting the safest treatment for children with fever therefore continues. The fact is that the evidence in these matters is continuously evolving and often the subject of controversy. Even where a degree of certainty has been attained, it is likely to involve qualified conclusions.
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