The needs of the many...

How generous are you?

Would you, for instance, be prepared to put your health at risk in order to prevent a total stranger having a heart attack? How about if that heart attack is, at present, purely hypothetical and may not happen for years, if at all?

Increasing numbers of patients in this country have been put on statins in the last decade, amid spiralling obesity and more aggressive prescribing of the medications by family doctors, whose pay is linked to take-up of the pills among their patients.

The pills, which cost the NHS less than 10p per patient per day, are now the most commonly prescribed medication in Britain, with eight million people on some type of anti-cholestoral drug. 

So convinced are the hard-line advocates of statins that they would like to see them routinely prescribed for the general population.

Some cardiologists have suggested they should be automatically prescribed to all patients from the age of 50, but others have said they are “disturbed” by the trend to dispense the pills ever more widely, exposing millions to potential side-effects.

But the benefits of statins outweigh the risks; the scientists have said so.

Research has suggested up to one in five patients taking the drugs suffers some kind of ill-effect, including muscle aches, memory disturbance, cataracts and diabetes.

That's a pretty nasty collection of  potentially serious and irreversible health problems, particularly if you were in perfect health before you started taking the pills. As new, improved versions appear on the market, more side-effects are bound to follow.

Atorvastatin was linked to one extra case of diabetes for every 160 patients treated.

Most serious of all is the widely-ignored problem of statin side-effects masking the symptoms of life-threatening conditions. All those muscle pains, kidney problems, headaches and jaundice could be the effects of the statins, but they might also be indications of serious disease.

By the time your doctor has swapped brands, changed the dosage and finally decided it wasn't the statins after all and he really ought to run some tests, it may well be too late to do anything about it.

But the benefits of statins outweigh the risks; the scientists have said so.

This is essentially the Trolley Problem - you can save five people from a runaway train by sacrificing one man. The Utilitarian principle says this is justifiable, even if he would otherwise have led a long and healthy life.

But in this case, we don't really know whether the train would actually have hit the five people, or killed them outright even if it did; according to the author of a recent book on statins (quoted in Saga magazine):

If you’re at high risk of heart disease or stroke and you take a statin for 30 years, you’re likely to live an extra nine months.

If that's true, it hardly seems worth risking the debilitating side-effects that, if universal prescription for the over-50s went ahead, could affect millions of previously healthy people, let alone the premature deaths from undetected cancer.

But the benefits of statins outweigh the risks; the scientists have said so.