The ethical dilemma posed by unmonitored new anticoagulants.
Although the dilemma of the absence of a reversal agent1 has been resolved for dabigtran, thanks to the advent of idaricizumab,2 the abiding dilemma which transcends all others is an ethical one, best summed up by the observation which reads as follows:-

‘With the NOACs (new anticoagulants) we cannot check INR or the equivalent of a parameter such as TTR (time in therapeutic range) and thus, we perhaps lose one powerful tool to predict anticoagulant …