Using the active, we write, ‘He made the incision…’ using the passive, ‘The incision was made…’. An established but not absolute convention (see p. 150) was for all scientific writing to be in the passive voice.

Unfortunately, this allegedly fundamental principle (which is increasingly open to question) also makes scientific writing ugly and unwieldy. It is to some extent a matter of fashion, but fashion is now turning against the passive.

When the passive voice is used, the writers take a back seat, as if they had watched the study from a distance: It was decided to; three measurements were taken. The passive forces constructions such as It was necessary to and This necessitated instead of We had to. Medical writers may be reluctant to use the active voice because of a fear that the first person sounds somehow immodest. Used sensibly it does not, but it does lend a paper a directness that gives readers the sense that the writers actually did the work, or hold the opinions, that they describe.

This, the first sentence from an unsigned editorial in the Lancet, is more effective than the passive equivalent The therapeutic potential of fish oil was discussed in an editorial in this journal last year.