I like guidelines. They make life simple. In the sense that you can probably save yourself some time by not having to think too much, maybe squeeze in a coffee. But also in the sense that they can demystify – protect from increasingly spurious meddling.

But Iona Heath in the BMJ reminds us of Karl Popper's words: "It might be well for all of us to remember that, while differing widely in the various little bits we know, in our infinite ignorance we are all equal." Do we by using guidelines seek to bend reality to match our beliefs?

Of course there are brilliant researchers out there who are exploring issues of health and disease, but for most of us doctors, we just get handed down some verbal or written dogma which we get no say in, and often conflicts with our personal experience. Authoritarianism in health, as elsewhere, is a barrier to scientific progress.

Ultimately, a clinical decision is always our own responsibility, we must judge whether it is moral to defy authority for the sake of right-doing. As Kant wrote, "Sapere aude!" Dare to use your intelligence!