The goal of pathology guidelines is to improve diagnosis and therapeutic decisions and to standardise practice. Lenzer et al1 have made proposals on how clinical guidelines ought to be created and phrased, with an even-handed presentation of evidence in cases where two or more alternative interpretations could be equally evidence-based. They recommend writing guidelines not to be interpreted as ‘rules’ and allowing for alternative practices by presenting ‘minority reports’ in which the arguments for alternative practices are presented. In pathology, the WHO classifications of tumours and other documents such as the templates from the College of American Pathologists (CAP) ultimately become de facto norms (ie, ‘rules’). Some laboratory information system software does not allow pathologists to sign out if required elements are not included, as defined by these guidelines. In this letter, we discuss some of the problems arising from such guidelines and make proposals that could...]]>