Press release

Spare the rod, spoil the child?

p. 805  Slapping and spanking in childhood and its association with lifetime prevalence of psychiatric disorders in a general population sample — H.L. MacMillan, MD; et al [full article]

p. 821  Is it time to ban corporal punishment of children? — M.A. Straus, PhD [full article]

Spanking as a means to discipline a child remains one of the most hotly debated issues among professionals who work with children and families. However, little information is available on the prevalence of and outcomes associated with a history of slapping and spanking in childhood.

In their study of a 4888-person subset of the Ontario Health Supplement Survey, Harriet MacMillan and colleagues found that individuals who reported being slapped and/or spanked "sometimes" or "often" were twice as likely to report current alcohol abuse or dependence. They were also twice as likely to have externalizing problems such as illicit drug abuse or dependence or antisocial behaviours compared with adults who did not report being slapped or spanked as a child.

Canada's Criminal Code currently allows for the disciplining of children by teachers and parents "if the force does not exceed what is reasonable under the circumstances". In a related editorial, Murray Straus ponders whether it may be time to join countries such as Sweden that have banned spanking.

p. 825  Tuition fees for residents: one physician's perspective — Brian Cummings, CA, MD [full article]

Brian Cummings is a rare mix: he is both a physician and a chartered accountant. In this issue, he offers his perspective on the issue of levying tuition fees on residents. The fact that tuition fees represent only 20% of the true cost of education and that physicians earn higher-than-average incomes upon graduation, seem to support the imposition of fees. However, Cummings asks, if tuition costs should rise to market levels, shouldn't resident wages rise to the same level to reflect the amount of training required, the skills demanded, the responsibilities undertaken and the time expended?

p. 813  Fairness in the coronary angiography queue — David A. Alter, MD; et al [full article]

p. 823  Waiting for medical care: Is it who you know that counts? — S.E.D. Shortt, MD, PhD [full article]

David Alter and colleagues divided 357 patients booked for coronary angiography at the Sunnybrook site of Toronto's Sunnybrook & Women's College Health Sciences Centre into 3 groups to identify why some patients waited longer than others. The 3 groups were based on whether the referring physician practised at Sunnybrook, practised at another centre but performed angiography at Sunnybrook or had no previous association with Sunnybrook.

The authors report that while most (65.3%) patients received angiography within the recommended maximum waiting time, physician affiliation alone accounted for 9.3% of the variation between the 3 groups of patients.

In a related editorial, Sam Shortt questions the decentralized, ad hoc fashion in which waiting lists are run in this country.

Sir William Osler
• Osler of reputation and the man
• Reputation unrevised: celebrating the Osler sesquicentennial
• William Osler at 150
• Tea with Sir William Osler
• Did Osler suffer from "paranoia antitherapeuticum baltimorensis"?
• Osler's unusual case — Was it Churg­Strauss syndrome?
• Osler usque ad mare: The SS William Osler
• The virtual Dr. Osler

This year marked the 150th anniversary of the birth of Sir William Osler, who was the world's most famous physician at the beginning of this century. In honour of the sesquicentennial of Osler's birth in Bond Head, Canada West, on July 12, 1849, CMAJ is presenting a collection of articles examining the man, his work and why his reputation still endures.

It is never easy to measure the greatness of an individual who lived in another time. The collection of articles presented here attempts to do that. Perhaps Osler's legacy was summed up best by historian Michael Bliss, who writes on page 833: "Osler understood and taught that the essence of medicine was the confrontation between a physician and a sick person. He became a great hero to students at McGill, Pennsylvania, Hopkins, and Oxford because he taught them not the sciences of medicine but the art of medicine in the light of science."