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ethics

Clinical Ethics Conference: London 8-9th July 2010

13 Jun, 10 | by Deborah Kirklin

On the 8th and 9th of July 2010 the Faculty of Health and Social Care at London South Bank University will be hosting a pioneering conference focusing on Best Practices in Clinical Ethics Consultation and Decision Making. For the first time in the UK, this conference will bring together an international and inter-professional dialogue between different stakeholders with the aim of fostering and developing best practice in clinical ethics consultation and decision-making across all sectors of healthcare. more…

The Landscape of Lesotho

10 Apr, 10 | by Ayesha Ahmad

Lesotho is one of the highest countries and is entirely landlocked by South Africa. 40% of Lesotho’s population survives on less than $1.25 a day. In centuries gone by, the people of Lesotho were driven high up into the mountains by the Xhosa and Zulu people and have repeated a solitary and isolated life, mainly farming, ever since. However, Lesotho is also experiencing one of the highest rates of HIV/AIDs infection rates in the world. This is their modern day crisis. What does survival mean in this situation? How can we conform to a meaning of being human when our human situations differ so dramatically?

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Why David’s Gray death was predictable

5 Feb, 10 | by Deborah Kirklin

A lot has been written recently about the 2004 contract that allowed GPs to opt out of  providing care to their patients at night or on the weekend. And about the fact that GPs are now paid more for doing less than ever before. I’m old enough to remember doing nights and weekends on-call and visiting elderly patients on a regular basis in their own homes with the aim of keeping them well.  And then I had a few children, and worked part-time for a while, and then the new contract came in, and GPs no longer did their own on-call, and the requirement to provide enough appointments in surgery, along with the obligation to ensure that every action and thought was entered on the computer meant there was less and less time to do other things. Things like visiting elderly people who weren’t ill as a means of keeping them well and providing them with the human contact we all need to thrive.

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Whose autonomy is it anyway? Drawing back the curtain

3 Feb, 10 | by Deborah Kirklin

A few weeks ago our first year students were thinking about patient confidentiality and it was my task to facilitate the process. The group I was with were from diverse cultural backgrounds and from several different countries, including the UK. Whilst they all readily grasped the idea of respecting  confidentiality as a way of respecting autonomy, some came from cultures where doing so was less important than it is for the average UK patient. Last weekend, visiting an elderly relative in hospital in Germany, I was reminded of that conversation.

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“In Praise of Hypochondria” by Miles Little and Claire Hooker

17 Dec, 09 | by Deborah Kirklin

We have been discussing the role of the humanities in medical education, and the need to account for what one of us calls ‘medical paranoia’. By this we mean the tendency that medical students (and practising doctors) have to think that they have developed serious illnesses, making self-diagnoses frequently based on vague suggestions rather than hard evidence. We feel that it is time to reflect on the significance, meaning and potential utility of this phenomenon. more…

In Sickness and In Health

10 Dec, 09 | by Ayesha Ahmad

Crossing borders always presents the potential for a hold-up. When I prepared to cross the border from Macedonia (or Skopje if you are Greek), into the tiny nation of Kosovo, preparation was the key. I had one mission: to visit the hospital in the capital, Pristina. I travelled by car to the border where a contact of mine in Macedonia had arranged for another car to meet me and drive me across to the other side. I would be travelling with an ethnic Albanian who was well-versed in dealing with the officials. Macedonia has experienced its war wounds in recent years but in Kosovo these wounds are healing but very visable. Lines of hardship tell the story of the past across many faces that I saw. more…

District 9 and Man’s Inhumanity to Man: a filmic guide to dehumanisation

28 Sep, 09 | by Deborah Kirklin

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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What if you haven’t got a flu friend?

17 Jul, 09 | by Deborah Kirklin

There are always, within the population, individuals who have no one to collect medicines for them when they are ill. The group predominantly affected are the elderly but, especially in a situation in which a significant proportion of the population is affected by a flu pandemic, there will be others. In normal circumstances we have a tried and trusted system of asking local pharmacies to deliver medications, including emergency medications, to people’s homes. more…

Homelessness: what’s the right response?

13 Jul, 09 | by Deborah Kirklin

Over the weekend, mixed with the harrowing coverage of the loss of soldiers’ lives in Afghanistan, and for news cycle reasons I’ve inadequate information to understand, the fate of London’s homeless population prior to the 2012 Olympics was discussed on television and in print. The organising committee of the London Games had apparently committed itself to ensuring that no one would be sleeping rough on London’s streets by the time the world’s elite athletes arrived. The question of the weekend was whether this goal would be achieved and at what price, both economic and in terms of human dignity. more…

In the UK government’s dystopian world patients told to ‘hang on’

9 Jul, 09 | by Deborah Kirklin

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…

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