many individual Christians fought for reform in some of these areas, but they were motivated more by their essential humanity than by the religious doctrine to which they subscribed. Bertrand Russell' once wrote that "it is amusing to hear the modem Christian telling you how mild and rationalistic Christianity really is, and ignoring the fact that all its mildness and rationalism is due to the teaching of men who in their own day were persecuted by all orthodox Christians". I would in fact lay odds that if the world succeeds in defusing the population bomb that religions have created, the Christian Church will find a way to take credit for this disarming feat. In passing, I would dearly love to know Jones's reference for his astounding statement that "humanism and other secular cultures typically struggle to suppress these freedoms of scientific investigation and democracy". As for my deciding to become a Christian, having spent many years under the weight of that dehumanizing, stultifying yoke and many more struggling to cast it off I am hardly likely to go back for more. That masochistic I ain't. Wolever seems to want to stretch the meaning of the word "religion" beyond recognition when he asserts that everyone has one. He should look up the meaning of the word. The Humanist Association of Canada, along with Humanist groups in other parts of the world, has gone on record as declaring that Humanism is a life stance and not a religion. Finally, Wolever states that "Christians are explicitly admonished to care for the sick, the poor, the oppressed, orphans, widows and those in prison". Does he imply that Christians would not do these things without being "admonished" to do them? In reply to Dr. Athol Roberts' response (Can Med Assoc J 1990; 142: 202-203) to my letter I note that Roberts is strongly skeptical

of the scientific evidence of the strong correlation between being religious and being prejudiced. I note that he does not manifest a similar degree of skepticism toward "revealed truth". From the viewpoint of cultural evolution, perhaps it is premature to label the human species homo sapiens:

homo religiosus might be more appropriate. Roberts also suggests that "since religious commitments are a fact of existence, there are sound pragmatic reasons for accepting patients and caregivers where they are rather than where some think they ought to be". The same could be said about heroin addiction, but the question is Should the CMA be promoting either? Wendell W. Watters, MD Professor emeritus of psychiatry McMaster University Hamilton, Ont.

had been receiving hypnotics before admission, whereas 139 hypnotic orders were written for the same 100 patients while they were in hospital. Although O'Reilly and Rusnak did not comment on the appropriateness of hypnotic prescribing in their paper, this question was addressed by Tait and Hall.3 As part of their study to determine the benefits of clinical pharmacy practice on a psychiatric unit Tait and Hall developed five criteria for judging the rationale of hypnotic prescribing. On the basis of these criteria 34 out of 50 orders for hypnotics were felt to be inappropriate. Deciding that changes in prescribing behaviour need to be made is relatively simple, but producing lasting changes will not be easy.4

Reference

Joel Lexchin, MD, CCFP (EM) 121 Walmer Rd. Toronto, Ont.

1. Russell B: Why I Am Not a Christian, Unwin, London, Engl, 1967: 35

References

The use of sedative hypnotic drugs in a university teaching hospital T n he call by Dr. Richard O'Reilly and Conrad Rusnak (Can Med Assoc J 1990; 142: 585-589) for an end to the practice of routinely writing orders for hypnotic drugs on a patient's admission to hospital is eminently sensible. Previous studies have shown that these drugs are excessively prescribed for hospitalized patients. Enriquez and Andrews' found that 85% of 101 medical and surgical patients received an order for hypnotics, yet 63% had rarely or never taken hypnotics before their current hospitalization. In a chart review of 100 patients Wing, Broughton and McLean2 found that only 15

1. Enriquez SG, Andrews JD: Effect of hospitalization on hypnotic drug use. Can J Hosp Pharm 1985; 38: 86-89, 107 2. Wing DS, Broughton R, McLean WM: A retrospective chart review of hypnotic use. Ibid: 48-52 3. Tait P, Hall D: Pharmacy involvement on a psychiatric unit at St. Paul's Hospital. Can J Hosp Pharm 1978; 31: 201-204 4. Soumerai SB, Avorn J: Efficacy and cost-containment in hospital pharmacotherapy: state of the art and future directions. Milbank Mem Fund Q 1984; 62: 447-474

Junk mail A s a resident in neurology who also has his general licence I have the misfortune to receive unsolicited mail aimed at both neurologists and general practitioners. To my delight I have recently discovered the feature in the CAN MED ASSOC J 1990; 142 (10)

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