Aspirin for everyone over 50?

Editor—Surprisingly, Elwood et al let the medical profession off the hook about the risks of aspirin prophylaxis for myocardial infarction.¹ To put the onus of decision taking on the patient, instead of the doctor being an informed mentor in the fight against vascular disease, is alarming.

How is the concept that “each person, not a doctor, should evaluate the risks and benefits” valuable in making a decision to a patient who is unaware of drugs and pharmacotherapeutics? The authors also advise that patients “are likely to accept a small increased risk of bleed or other side effect in exchange for a reduced risk of a heart attack or stroke.” This is indirectly offered medical advice from doctors. Passing the buck is impossible when the buck stops here, in the consulting room.