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Though women have always been able to exercise some control over the risk of an unwanted preg nancy, the availability of effective and acceptable contraceptive methods and of abortion have made voluntary control of fertility by the individual simpler and more certain than ever. The object of this paper is to examine the degree and features of self-selection for pregnancy in one community (Aberdeen) in the 'pre-pill' era and to assess the implications of an increase in fertility control for the interpretation of national and hospital statistics.

The patients in the ear, nose, and throat wards were under the care of Mr. C. P. Wilson, Mr. J. P. Monkhouse, and Mr. D. Ranger, and I thank them for permission to carry out the trial. I also thank Dr. J. D. N. Nabarro for his criticisms and en couragement in the preparation of the paper; Mr. M. P. Curwen, of St. Bartholomew's Hospital, for his invaluable help with the statistics; Dr. Margaret Briggs, of Roche Products, for the pre paration and dispensing of the tablets; and the night sisters and their nursing staff, whose enthusiastic co-operation made this trial nnssiileh REFERENCES Brandman, O., Coniaris. J., and Keller, H. B. (1955). J. med. Soc. N.J., 52, 246. Cass, L. J., Frederik, W. S., and Andosca, J. B. (1955). New Engl. J. Med., 253. 586. Hare, E. H. (1955). Brit. J. prev. soc. Med., 9, 140. Kemper, H. (1955). Dtsch. med. Wschr., 80, 1034. Schmitt, W. (1955). Med. KlUn., 50, 1223.

This paper discusses drawing up a restricted list of 245 drugs for use in an inner London group practice, based on a review of prescribing patterns in November 1982. The likely impact of the recent proposals by the Department of Health and Social Security to limit drugs available for prescription under the National Health Service on this project and on patient care is considered. We conclude that generic prescribing and a limited list of drugs may improve the quality of prescribing and be the only way to curb prescribing costs but that a limited list should be flexible, responsive to patients' needs, and applied to all prescribing. There should also be a mechanism for consumer feedback and regular revision of the list.

AIDS has joined suicide as a barrier to the accurate certification of death as required by law in Great Britain and the U.S. Despite acknowledging the importance of accurate records for medical, epidemiological, and insurance purposes, and because registers of death are public records, sympathetic physicians may substitute other causes of death or omit stating the underlying diagnosis of HIV infection in order to spare families of the deceased the added psychological stress caused by stigmatization. Many physicians believe that informing public health authorities is sufficient. To preserve privacy and the confidentiality of medical information a British government paper has suggested that, with reference to sensitive causes of death, recent records be available only to those who have a legitimate reason for wanting them. In the U.S., the adoption of a two-part death certificate has been proposed, one for immediate legal purposes and the other for medical certification.

The purpose of this paper is to call attention to what appears to be the relentless march of the psychotropic drug juggernaut. At a recent symposium, at which the prescribing habits of general practitioners came under scrutiny, Harman stated, "Opinion is growing that in the use of psychotropic drugs we may be evolving a dangerous monster, not by intent but by unplanned increments."' How justified this alarm call was is a matter for debate, which must necessarily be based on an examination of available statistics.

It was with some misgiving that I read in my morning paper that as from 1 April 1974 all contraceptives are to be made available on National Health Service prescription. Some 7 months ago my partner and I found that the number of women in our practice on the pill was assuming such proportions that we were unable to be as thorough in our 6-monthly check-ups as we wished. We therefore decided to employ on a sessional basis a woman doctor who devoted all her available time to family planning work. The result has been most encouraging and the 75p for prescribing the pill has been a great help in her renumeration. Can I take it that as from 1 April 1974 family planning will be yet another item the general practitioner must carry out with no extra renumeration? If so I am sure a great many G.P.s will discontinue any form of regular examination for these women. Even at the present time numerous women arriving in this area have been astonished to learn that they are unable to obtain a repeat prescription without an examination. So far as condoms are concerned I did not study medicine with the ideas of supplying these articles. If the general public are to have condoms on the N.H.S. I suggest that family planning clinics supply them or possibly the local health or welfare departments. As a medical examination is not necessary before a condom is worn I do not propose to issue prescriptions for these articles and feel that many G.P.s will follow suit.(FULL TEXT)