I am fortunate enough to count Professor Jonathan Glover, a world renowned medical ethicist, amongst my former teachers. A very modest and thoughtful man, Jonathan Glover spent a number of years writing a similarly thoughtful book in which he tries to understand what he terms man’s inhumanity to man (Humanity: a Moral History of the Twentieth Century. Pimlico, London 2001). His starting premise is that, given the wrong circumstances, we are all capable of doing evil things to other human beings. At the heart of his efforts are a desire to understand, for all our sakes, what it  has taken in the past, and by extension what it would take in the future, for people- just like you and me- to be willing to take part in our own equivalent of the Holocaust and the Rwandan genocide.

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If you want to refresh your memory of the comings and goings in Geroge Eliot’s classic, Middlemarch, then look no further than Professor Rosin’s analysis in the June 2009 issue of Medical Humanities.

http://mh.bmj.com/cgi/content/short/35/1/43?q=w_mh_current_tab

If you want to follow a contemporary equivalent of medical marketplace machinations then you need look no further than what is currently happening to general practice in England and Wales. And specifically to the Orwellian world in which carers and cared for find themselves. A world where government announcements to the national news media of the universal introduction of Cognitive Behavioural Therapy are followed by the systematic reduction of mental health care services in primary care. In my own practice, in the past 6 months, first the PCT provided mental health care worker was removed and more recently the practice counsellor of 17 years standing was ‘let go’. But hey ho, never mind, NICE guidance has after all told us what to do: if a patient is suitable for CBT and it isn’t available (!) we can (and should) tell them to ‘hang on’. more…

As I write, much of the information rich world is focussed on the precarious state of the highly interrelated global financial structures. For many others, the daily struggle to survive, coupled with lack of access to minute-to-minute updates about these unsettling events, means they remain unaware of the economic drama unfolding around the world. This, unfortunately, will not protect them from the inevitable fallout of these disturbing developments.

The relationship between health and poverty is well established. The reliance of a large proportion of the world’s population on cheap food has been brought into stark relief by  food riots in a number of countries, sparked by rising food prices and the hunger and fear this inevitably evokes. 

Even in so-called emerging markets- those parts of the world like China and India where growth far outstrips that in older more established industrial economies- there is rising concern about what a collapse of the financial system would mean for these fledging economies.

So as politicians in Washington struggle to find it within themselves to vote for an expensive bailout that might lose them their jobs come the November US elections, I wonder if it is anything other than naive to ask them to contemplate the human dimension, within and well beyond America, of their decisions. To echo a well worn metaphor, if America catches pneumonia not only will the world sneeze but many many people around the world will find themselves out of work, unable to eat and care for themselves and their families, and life expectancy for the poorest and most vulnerable in all parts of the world will shorten.  more…