This study is based on a critique of Western medicine derived from the proposition that any system of medicine must necessarily embody a mysterious quality. What is meant by mystery is an all encompassing element of indeterminancy and so of uncertainty in both the theory and practice of medicine.

Ted Shotter's founding of the London Medical Group 50 years ago in 1963 had several far reaching implications for medical ethics, as other papers in this issue indicate. Most significant for the joint authors of this short paper was his founding of the quarterly Journal of Medical Ethics in 1975, with Alastair Campbell as its first editor-in-chief. In 1980 Raanan Gillon began his 20-year editorship . Gillon was succeeded in 2001 by Julian Savulescu, followed by John Harris and Soren Holm (...) in 2004, with Julian Savulescu starting his second and current term in 2011. In 2000 an additional special edition of the JME, Medical Humanities , was published, under the founding joint editorship of Martyn Evans and David Greaves. In 2003 Jane Macnaughton succeeded David Greaves as joint editor. Deborah Kirklin, under whose auspices MH became an independent journal, took over in 2008, and she was succeeded in 2013 by Sue Eckstein. This short paper offers reminiscences and reflections from the two journals’ various editors.From the start the JME was committed to clearly expressed reasoned discussion of ethical issues arising from or related to medical practice and research. In particular, both Edward Shotter and Alastair Campbell, each a cleric , were at pains to make clear that the JME was not a religious journal and that it had no sort of partisan axe to grind.Campbell's appointment as founding editor was something of a surprise, as the original intention had been to appoint a medical doctor, who could be expected to know medical practice from the inside. However, in 1972 Campbell, a Joint Secretary of the Edinburgh Medical Group, had published Moral dilemmas in medicine. …. (shrink)

There has been a modern epidemic of heart attacks in the western world, and this paper is concerned with this ‘new’ medical condition and how it arose. Two competing theories are commonly proposed, relating either to conventional accounts of medical science, or to social construction. Whilst recognising that aspects of both theories have some validity, it is claimed that neither is wholly adequate. This issue has particular relevance for heart attacks and is explored in some detail, but it also points (...) to some more general conclusions. First that medical knowledge cannot be separated into ‘scientific’ and ‘social’ compartments but is united by its human aspect; and second that although medical knowledge has a special dimension, when understood in this way, it may also resonate with a more general re-examination of the relationship between scientific and human knowledge. (shrink)

There has been a modern epidemic of heart attacks in the western world, and this paper is concerned with this ‘new’ medical condition and how it arose. Two competing theories are commonly proposed, relating either to conventional accounts of medical science, or to social construction. Whilst recognising that aspects of both theories have some validity, it is claimed that neither is wholly adequate. This issue has particular relevance for heart attacks and is explored in some detail, but it also points (...) to some more general conclusions. First that medical knowledge cannot be separated into ‘scientific’ and ‘social’ compartments but is united by its human aspect; and second that although medical knowledge has a special dimension, when understood in this way, it may also resonate with a more general re-examination of the relationship between scientific and human knowledge. (shrink)

Commentator: Mark Purvis Commentator: Sheena McMain Commentator: Clare Connolly Commentator: Maggie Eisner Commentator: Shirley Brierley Commentator: Becky Ship.

ABSTRACT The assumptions underlying the traditional biomedical model of health and illness and criticisms of it are described. An examination of the historical development of ideas concerning cot (crib) deaths shows how early explanations, which were congruent with this model, came to be discredited. Because subsequent explanations have also been considered unsatisfactory, cot deaths have come to be regarded as medically problematic. The relationship of models of health and illness to cot deaths has therefore been exposed to an unusual degree (...) of scrutiny. Two possible contending models, social epidemiological and socio‐economic are identified, and their status vis‐à‐vis the biomedical model is considered. The choice as to which of these models is applied to cot deaths is shown to be not only of theoretical interest but also to have ethical implications for health care policy and medical practice. (shrink)

Armstrong describes the rise of a new mode of medical practice that he calls in the following terms: Surveillance medicine gives rise to a novel and underexplored aspect of the long-standing tension between the different goals of clinical medicine and public health.

A collection of essays that cover a range of topics of relevance to health care professionals. The book is intended to fill a gap between introductory texts on medical ethics and in-depth specialized books. It shows the importance of combining philosophical and ethical discussion.