The banner “The end of doctor knows best” was just one of the many eye-catching newspaper headlines which accompanied the publication of the Kennedy report¹ into the outcome following paediatric cardiac surgery in Bristol. Professor Kennedy highlighted the need for health care professionals to work closely with patients, and parents, in decision making relating to their health care. “Trust me I’m a doctor” was no longer good enough and the paternalism which had pervaded medical practice during much of the last century had to end. He, of course, had contributed hugely to opening up this debate in his Reith lectures (“Unmasking Medicine”) some 20 years before the Bristol report.² He wrote “If illness is a judgement the practice of medicine can be understood in terms of power. He who makes the judgement wields the power”. The Royal College of Physicians’ recent report on …