We read with great interest the leading article 'Lest we forget...'.1 The authors give a compelling account, against a historical background, of the importance of ethical review of research trials, and the tension between improving the health of the pae-diatric population versus the rights of the individual child. Although there is a lot of truth in the 'therapeutic orphan' status of paediatric patients (given the historical dearth of pharmacological research in paediatrics), there is an opportunity for any clinician involved in the care of children to improve the health of the entire paediatric population without encountering ethical dilemmas: reporting paediatric adverse drug reactions (ADRs) through the UK's yellow card scheme. Much drug data, used in children, on efficacy and safety has been extrapolated from adult trials. This has led to the use of off-label and unlicensed medications in childre"n, a practice associated with a higher risk of ADRs.2 3 Children may also suffer different ADRs from adults (eg, growth suppression).
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