At the beginning of 1999 the British Society of Gastroenterology (BSG) issued guidelines for informed consent for endoscopic procedures.1 This is the eleventh booklet in the Guidelines in Gastroenterology series, all of which contain excellent advice. But is there a down side? Is the practice of medicine becoming too prescriptive?

Firstly, I must come clean. In 1995 I wrote the initial draft of the document on informed consent for endoscopic procedures at the request of Duncan Bell who told me that the BSG Council had commissioned the exercise some years previously, that those nominated had reneged and that the honour of East Anglian gastroenterologists was at stake. Duncan Bell and I aimed to keep the document short and tried to stress two central messages: firstly, the importance of speaking with patients and, secondly, the need for clinicians to devise their own method of ensuring that patients were guided wisely. In the ensuing three or four years the considerably expanded draft document shows all the signs of having been re-written in committee (on several occasions considering the length of gestation). Political correctness …