The last time I penned a concise argument for the Journal I focused on articles which raised interesting questions about the interplay between evidence and ethics in healthcare practice. Two articles in this month's issue highlight once more the importance of this relationship. The first is Meixel, Yanchar, and Fugh-Berman's article ‘Hypoactive sexual desire disorder: inventing a disease to sell low libido’ which is this month's editor's choice article. The second is Cate, van de Vathorst, Onwuteaka-Philipsen, and Agnes van der Heide's article ‘End-of-life decisions for children under 1 year of age in the Netherlands: decreased frequency of administration of drugs to deliberately hasten death’.

The ‘little pink pill’ & creating diseases?

One might be forgiven upon reading the popular press or various women's magazines for thinking that women are suffering from hitherto unseen pathological levels of low libido. Some example headlines from a variety of online publications include: ‘Low Libido in Women: What's Killing Your Sex Drive?’,1 ‘When Desire Dies: Bringing Your Sex Drive Back to Life’,2 ‘Why Do Women Lose their Sexual Desire?’,3 and ‘Sex Drive SOS: Find Out What's Behind Your Low Libido and Start Feeling Sexy Today’.4 There is no shortage of ways suggested in these pieces for women to combat low sex drive. Practically, what has been missing until very recently, however, has been a ‘little pink pill’; the so-called female Viagra.

In August this year this all changed. The Food and Drug Administration (FDA) in the United States gave its approval for a drug to treat what has been called generalised hypoactive sexual desire disorder (HSDD). Flibanserin, although approved for use in men or women, is the first drug that has been approved to treat the disorder in women.* The accompanying press release from the FDA had the following statement: ‘Today's approval provides women distressed by …