Trends in health care and their effects on medical education.

assert that some person's conduct is scandalous. He or she must first set out and explain, or at least allude to, the conduct in question (which must be true) and only then is it permissible to give a comment on it. For example, to state that a surgeon was guilty of a gutless abdication of his responsibilities would not be defens? ible as fair comment unless the author also made clear the basis for this comment?for example, that the surgeon had resigned on the ground that he objected to the introduction of new pay codes. The defence of fair comment would also not succeed in this instance if in fact the basis for the comment turned out to be incorrect and the surgeon proved that he had, for example, retired on grounds of ill health. It is important for authors to ensure that what they are saying is in fact comment and not simply an allegation dressed up to look like an expression of opinion. If the allegation, although expressed in the language of comment, is likely to be read as an assertion of fact?for example, "Dr A would appear to have broken every rule in the book"?the defence of fair comment will not apply and the appropriate defence to consider is that of justification. The boundaries of fair comment are wide and, providing authors are commenting on true facts, they are entitled to express their honest opinion, however forthright. Nevertheless, caution is advisable where an author is speculating about an individual's state of mind. For example, it is dangerous to say that some? one's conduct is plainly vindictive or that a person is evidently operating for reasons of personal profit. It will always be hard to convince a court that such inferences about an individual's personal motivations are fairly to be drawn from the surrounding facts of the case.