The Pharmaceutical Journal
Vol 276 No 7398 p510
29 April 2006

This article
Reprint   Photocopy

PDF 60K, Acrobat Reader

Spring “crowned with milk-white may” more
Dealing with moral objections to the dispensing of particular drugs more
Tricky problem of predicting the economic effects of global warming more

Spring “crowned with milk-white may”

For centuries the first day of May has been a time for celebration and rejoicing. In Roman times the calends of May was the time when people were called together by the pontifex to learn the time of the new moon and the festivals to be observed during the month. Roman youths went out into the fields and spent the day dancing and singing in honour of Flora, goddess of flowers, youth and spring.

In England bands of youngsters ventured forth on the morning of May Day to collect boughs of hawthorn (whitethorn) and sycamore and bunches of fragrant herbs, which served to decorate the maypole which was at the centre of the festivities. Activities included archery and morris dancing.

In the 16th century May Day was Robin Hood and Maid Marion’s day, when characters representing those worthies cavorted in villages. Chimney sweeps paraded through some streets of London and before dawn the choristers of Magdalen College, Oxford, ascended the college tower to greet the arrival of the new day.

The change in the calendar in 1752 meant that the traditional first blooming of the hawthorn, Crataegus monogyna, in many places was delayed until after May Day, but this was a minor deterrent.

The blooms were regarded as a protection against witches and were therefore frequently used to decorate houses, although in some areas to take them indoors was said to bring ill-luck and a death in the family. The rather sinister odour, suggestive of decaying bodies, was probably to blame. One floral constituent, phenylethylamine, is reminiscent of putrefaction.

In folk medicine, to wash in dew from the hawthorn early on May Day would guarantee a healthy complexion. Samuel Pepys comments that his wife would go to Woolwich for the sake of “laving her face with may dew”.

The plant contains flavonoids and aesculin, and decoctions of it have been employed for diuretic, astringent and tonic purposes.

Back to Top

Dealing with moral objections to the dispensing of particular drugs

Human society embraces three main types of individual. There are those whose utter selfishness blinds them to the needs of others and makes them antisocial. There are others whose fanaticism overrides any reasoning process and there are yet others who face the necessity for making moral judgements when any doubtful situation arises, and who are aware of the pitfalls in their path.

Judgements may affect professional services offered by experts. Among these are pharmacists. A comment published in the 15 April issue of The Lancet concerns the refusal of pharmacists in the US to dispense some prescriptions offered them. The issue was sparked off when a pharmacist in Texas rejected a prescription for an emergency contraceptive on the grounds that it constituted “a violation of morals”. It is argued that health care providers, including doctors and pharmacists, have the right to refuse to participate in services to which they morally object.

The policy of pharmaceutical institutions in general is that those who object to providing the product should ensure that the need will be met elsewhere or by another hand. But such a solution is complicated by factors such as insurance arrangements and transport difficulties. In Illinois pharmacists must dispense contraceptive drugs when a valid document is presented, and unfilled prescriptions for such drugs may be confiscated. The responsibility rests on the business rather than on the individual. Automated delivery systems might be used to overcome the moral aspect.

Pharmacies should require that their pharmacists, as a condition of employment, must agree never to abandon their patients irrespective of any personal and moral objection they may feel in relation to a particular drug or its practical application.

Nevertheless the situation does present difficulties in the shape of a choice between approval and disapproval. Ethical standards, however incapacitating they may prove in everyday practice, demand attention to the best of an individual’s ability.

Back to Top

Tricky problem of predicting the economic effects of global warming

Global warming is a phenomenon that has been making its challenge increasingly more evident from week to week, until even the sceptics among politicians find it impossible to avoid facing it.

Any discussion of global warming involves many uncertainties, and the economic assumptions on which critics base their arguments become outdated and unreliable. In the 26 January issue of Nature, Quirin Schiermeier reviews some of the doubts that arise when the problem is treated theoretically.

Economics is a field in which meteorologists are not normally qualified to tread. Some have assumed that the economics of poor countries will rapidly catch up with those of rich nations under the stimulus of global warming, and that this will increase their carbon emissions and make the situation worse.

However, others take a different view. According to meteorologists in Hamburg, global temperatures are likely to rise by 2.5–4.0C by 2100. Their calculations were based on estimates of carbon dioxide concentrations of 550, 700 and 800 parts per million.

The most optimistic assumption suggested that the Arctic would become ice-free during summer 2090. Global sea level would rise by an average of 30cm, and by an additional 10cm as part of the Greenland ice sheet melts. The Atlantic Ocean circulation would weaken but not cease. Rain and snow at high latitudes and in the tropics would increase, with less rainfall in the Mediterranean and subtropical regions. There would be more precipitation and extreme drought worldwide.

A temperature rise of 3C has been calculated to reduce global income economically by 1 to 3 per cent. Economists and climate scientists need to compare notes, with a view to finding reliable ways of calculating the possible damages and costs.

Back to Top