A different kind of case report: I

Editors have long argued over the merits and otherwise of publishing case reports, and the power of the anecdote, despite their lowly ranking in the hierarchy of evidence. Indeed, case reports remain ever popular; as journals have shied away from a regular case report section, so has grown an increasing number of online case report resources (see for example http://www.anaesthesiacases.org/). The following account 1 by McGuire and Dalton is a case report in which the ‘case’ is not a clinical curiosity or challenge, but a project that started innocently enough but illustrates how easy it is for clinicians, keen to explore ways of improving the quality of care they provide, to run into trouble without realising it. McGuire and Dalton's tale should serve as a lesson to all those embarking on a clinical project, however it might be labelled, and emphasises how important it is to have: i) an understanding of the basic ethical principles involved in even the simplest study; ii) proper governance oversight of projects within organisations; and iii) awareness of the local regulatory processes and mechanisms. I commend McGuire and Dalton for their openness and willingness to share their experience and the lessons learnt, after what was evidently a rather unpleasant experience – after all, that's the whole point of case reports, isn't it? No external funding and no competing interests declared. I was the Editor-in-Chief to whom McGuire and Dalton refer in their editorial.