Medical ethics in Hungary has finally moved beyond arguments over tipping and bribes to discussions of euthanasia, confidentiality, truth‐telling and informed consent. Ethics committees have been formed at the local and national level, and medical schools are beginning to take seriously the systematic teaching of medical ethics. In some quarters, however, old attitudes persist. Among older doctors paternalism reigns supreme, and lawmakers continue to ignore international ethical guidelines.

The authors’ aim is to bring to the attention of readers the inadequacies of care for people in Hungary who are terminally ill. They believe that both objective and subjective factors cause these inadequacies. Most of these factors arise from moral dilemmas that could be eased or even solved if ethics education had a much more prominent place in the nursing curriculum. Even if nurses would not become automatically better persons morally, a much wider knowledge of medical/nursing ethics could significantly (...) improve nursing care both before and at the end of life. Although the article is also critical of the nursing care provided, it is not its purpose to make any generalizations. The study utilized selected passages from essays written by 76 practicing nurses on their personal experience of ethical dilemmas in their work environment, and a questionnaire administered to 250 students (registered nurses and health care students) studying for a college degree. This article is written by two authors who have formed an unusal alliance: a registered nurse with 29 years’ experience of bedside nursing, but who is currently a teacher of nursing ethics at a local health college, and a lawyer turned bioethicist. (shrink)

"Petty corruption and honesty in all health care systems" is the original title of one of the bioethics networks within the world-wide study projects of the International Association of Bioethics. As the co-ordinator of this network, it still puzzles me why the word "petty" is in the title when in the past few years - through interviews and questionnaires involving 18 countries - it has become evident to me that not only trivial but important, significant corruption exists in many health (...) care systems. (shrink)

In this article I discuss 'the transition' of Lithuanian health care. In order to illustrate the size of the difficulties the people of Lithuania presently face, I focus in particular on the problem of resource allocation. I believe my observations (both general and particular) reflect the experiences of other post-socialist countries, especially those nations which were directly incorporated within the former USSR. Certainly, the two other Baltic states -- Latvia and Estonia -- have a great deal in common with Lithuania, (...) both politically and culturally. I have identified four questions to act as a framework for my discussion: -/- • What were the main causes of the Soviet health care crisis? -/- • What was the basis for resource allocation in the former socialist health care system? -/- • What are the major obstacles set against the implementation of alternative principles of resource allocation in Lithuania? -/- • What ideas might underlie and inform the design of a new Lithuanian health care system? (shrink)

Book reviewed in this article: The Right to Be Born Healthy. By Andrew Czeizel.