To the Editor.
—I noted with interest 3 articles1-3 dealing with adverse drug reactions (ADRs) and their consequences. Since the hospital to which I admit my patients has started what they describe as a mandatory ADR reporting system, I have 2 points. First, in our institution, trivial events are required to be reported as an ADR. If a cancer patient receiving chemotherapy has nausea or loses his or her hair, that is an ADR; if an asthmatic patient develops mild hyperglycemia from receiving steroids, that is a reportable ADR; if a patient is given antacids for an upset stomach and develops a mild case of selflimited diarrhea, that is a reportable ADR. There seems to be little rational consensus on what constitutes an ADR.The second point is that physicians are in a double bind. If we do not make a selective report to the pharmacy about a