Medicine and Science from The BMJ

The House of Lord's amendments to England and Wales assisted dying bill might be causing a constitutional crisis. Lords have tabled 1,277 amendments—which is a record for any equivalent bill in history - and over half of those came from just seven peers. This has led to accusations of "delaying tactics" or "filibustering" to run down the clock deliberately and run this bill off the road. Although some of these amendments have been described as unworkable, repetitious and unnecessary; others reflect serious, legitimate concerns, around the prevention of coercion, how to identify victims of domestic abuse and the broader impact on the disabled community, and whether it’s wise to introduce assisted dying while palliative and social care services are so stretched. 300 territories around the world, allow physician assisted death - so we asked experts from Canada and California to reflect on those objections, and if there is any evidence of this issues arising where they live. James Downer is Professor and Head of the Division of Palliative Care at the University of Ottawa, and Catherine Forest is clinical associate professor of family medicine at the University of California San Francisco. Reading list: Scrutiny of the assisted dying bill is vital but obstruction in the House of Lords could mean it never becomes law

We’re 18 months into the Labour government, and their changes to the NHS are beginning to be felt. In the 10 year plan that they launched last year, they announced three planned shifts for the health service. Firstly, they pledge to move care from hospitals to the community, an increased focus on prevention rather than sickness, and shift from analogue to digital with an improved NHS app where patients can access records, seek advice and control some aspects of their care. However, accessing primary care and getting a GP appointment is still a key area of concern for patients and healthcare staff. In a new research paper on bmj.com, a group of researchers have performed a qualitative study asking 70 patients about their experiences of accessing primary care in England. We're joined by Hugh Alderwick and Luisa Petigrew from the Health Foundation to discuss what the findings mean for the 10 year plan. Also this week, online gambling is a growing problem. The immediacy of access, combined with advertising and push notifications, and a proliferation of new gambling companies, undermines traditional ways of managing a gambling addiction. A new analysis argues that these new forms of online gambling requires new forms of regulation. Spencer Murch from the University of Calgery offers some ideas on how that could work. Reading list Experience of access to general practice in England Policies to increase access to general practice may have unintended consequences Online gambling requires greater government regulation

The class of GLP-1 agonist drugs including Ozempic gained a wide reputation for weight loss in 2025. However, it's well established that weight regain is a common result after people stop their doses. We report on new research which aims to quantify what is happening in the here-and-now for patients who stop using these and similar drugs. Weight regain after cessation of medication for weight management: systematic review and meta-analysis Also, The BMJ reports on news from Gaza. The Israeli government has issued new directives to strip 37 NGOs of their licences to provide essential aid to the population. This includes Médecins Sans Frontières, the charity directly supporting many of the critically important hospitals in the territory. Gaza is experiencing an especially harsh Winter and MSF warn that this measure could leave Palestinians without lifesaving medical care. Gaza: Israel moves to ban dozens of aid groups in "cynical and calculated" move Gaza in winter: 29 day old baby dies of hypothermia amid dire conditions The BMJ’s annual appeal is supporting the work of Médecins Sans Frontières (MSF). Around the world, MSF teams are providing maternity care, containing outbreaks, and performing vital surgeries. In areas overwhelmed by conflicts and natural disasters, more lives can be saved when we are in the right place at the right time. Donate today at https://msf.org.uk/bmj-annual-appeal-2025

It’s time for 2025’s festive fun! Practicing medicine can be a very visceral experience - and the English language can’t always adequately capture the sights, sounds, smells. So Matt Morgan, intensivist and BMJ columnist, is creating medical neologisms, and joins us to share a few. Madhvi Joshi, a GP in London, has written about longevity science, and we hear how the “biohacking” of internet influencers like Bryan Johnson is making its way into the consultation. Navjoyt Ladher and Tim Feeny take us though this year’s festive research, and are joined by Anupam Bapu Jena from Harvard, who has been looking at self censorship in the time of Trump, and Melanie de Lange, from the university of Bristol, who has been investigating the impact of daylight savings time. Reading list: A dictionary for medicine’s unnamed momentshttps://www.bmj.com/content/391/bmj.r2476 Science of longevity medicine https://www.bmj.com/content/391/bmj.r2536 Changes in diversity language in National Institutes of Health grant awardshttps://www.bmj.com/content/391/bmj-2025-087222 Acute effects of daylight saving time clock changes on mental and physical health in Englandhttps://www.bmj.com/content/391/bmj-2025-085962

There is an enormous amount of research on treatment for ADHD - pharmaceutical and otherwise. But not all of those trials, or meta-analyses, are of high quality; and not many compare the whole literature. Now a new umbrella review - a review of reviews - tries to give a broad overview of the whole evidence base. Corentin Gosling, associate professor at the Université Paris Nanterre, joins us to set out the benefits and harms of ADHD therapies. Also, the BMJ’s been investigating the employment of doctors on “local” contracts in the NHS - and our latest look at this exposes what some have described as a “gig economy”, with doctors plugging rota gaps but missing out on training, development, and salary progression. Rebecca Coombes, head of journalism at The BMJ explains more. Finally, Tom Frieden is former head of the US Centers for Disease Control, and current CEO of Resolve to Save Lives - he’s written a new book on public health. He joins us to talk about what actually improves health at a population level, and why the current US administration’s approach to staffing the CDC is leaving the country open to danger. Reading list Benefits and harms of ADHD interventions: umbrella review and platform for shared decision making Revealed: Thousands of NHS doctors are trapped in insecure “gig economy” contracts

It’s the BMJ’s annual climate issue - and in this episode, we’ll be hearing about more ways in which climate mitigation is good for health. Firstly, climate change is fuelling conflict, and exacerbating the impact it has on fragile healthcare systems. Andy Haines, from the London School of Hygiene and Tropical Medicine, and Barbora Sedova, from Potsdam Institute for Climate Impact Research, discuss how climate and conflict intersect, and what they think needs to be done to combat it. “Car spreading”, the recent tendency for cars to become bigger and heavier is not only harming the climate, but it’s also harming pedestrians. Anthony Laverty, associate professor of public health at Imperial College London, and trauma surgeon Cleo Kenington explain why SUVs are more lethal in accidents, and why France is bucking the trend in sales. Finally, Jocalyn Clark, the BMJ’s international editor joins us to talk about women’s health innovation and why tech bros aren’t the people to be leading it. Reading list: The climate issue: Brazil and the climate crisis Tackling the complex links between climate change, conflict, and health Reducing the harms from ever larger cars Transforming women’s health through innovation

This week on the podcast The BMJ investigates Q-COLLAR, an American device that distributors claim can reduce brain injury from contact sports. Investigators James Smoliga and Mu Yang take us through the evidence, and former NFL punter turned US bobsled team member Johnny Townsend explains what this means for sportspeople. Bin Wang from Zhejiang University School of Medicine explains what the new network metaanalysis finds is the best exercise options for knee osteoarthritis And, what our patient panel really think about “patient choice”. links How an FDA cleared “brain protection” device built on shaky science made it to the NFL Comparative efficacy and safety of exercise modalities in knee osteoarthritis The BMJ's patient and public partnership