The history of the Institute of Medical Ethics has been well recorded. Accounts of its origins in the London Medical Group were published in an academic paper of 2003,1 in the transcript of a Wellcome Witnesses to Twentieth Century Medicine Seminar in 20072 and in a chapter of the 2009 Cambridge World History of Medical Ethics.3 In 2013, 50 years since the inauguration of its first series of lectures and symposia, the LMG as an organisation no longer exists, but its (...) aspirations and achievements are alive and well, both in the Journal of Medical Ethics and in the IME, now exploring a new phase as a membership organisation. Other papers in this issue will discuss the history and prospects of the Journal and Institute. But the LMG, similar medical groups in all other British medical schools and the Society for the Study of Medical Ethics from which the IME derived also have a significant continuing life in the thinking and practice of many medical and healthcare professionals who participated in their activities, and then in turn on those influenced by their thinking and practice. The LMG, it could be said, is ‘no more’ an organisation ‘Now but a whole climate of opinion’.4A bottom-up evolutionThe first medical students to be involved in the LMG may not have foreseen its influence on their future careers, but many were aware of being part of something new and exciting. One of those with whom the first lecture series was planned was Margaret Lloyd . "The beginning of the LMG in 1963 was an exciting time for medical students in London. As a mature student entering St Mary's Hospital Medical School … ". (shrink)

A practical and thought provoking introduction to the most important ethical issues in medicine today. Over 700 entries, from short essays to brief definitions of key terms and concepts, have been contributed by leading clinicians and medical ethicists.

The following case breaks with tradition by having only one commentary upon it, and that is from the doctor who submitted the case. We invite readers to make their own analysis of his comments, and to respond as appropriate.

Cognitive and rational assessments of competence do not fully capture the way in which individuals normally make decisions. Human beings have always used stories to explain their experiences and values. Narrative ethics should be used to understand the perspective in context of a patient whose competence is in question, and so avoid a destructive clash. Psychiatry and professionals within it also have a narrative that may join with that of science, but there is no special privilege for these narratives unless (...) survival is at stake. The narrative approach should be used to try to make different stories compatible. This article examines the background to this approach, and indicates some ways in which it could be used in the specific cases addressed in the series. (shrink)

The prelims comprise: The Clinical Task Truth and Truthfulness An Absolute Duty? Giving Reasons, Respecting Autonomy Codes of Conduct Harm and Benefit The Physician Herself Accuracy and Trust Talking to the Dying Diminished Understanding Increasing Complexity Being Prepared Gaining Skills Summary References Further Reading.

The dilemma of whether or not a doctor should tell a patient dying of cancer the truth remains a difficult one, as the disagreement between the two previous writers shows. One favours giving priority to patient autonomy, the other feels the doctor's duty of beneficence should be the overriding principle governing such decisions. To this contributor it seems both approaches have something to offer. By being sensitive to what and how much the patient wishes to know and by learning from (...) the insights provided by the study of medical ethics, doctors can learn how to make better moral decisions in this and in other areas. Both lying and truth-telling carry risks of harm to the patient. Learning to work with and balance these risks is part of clinical practice. So is minimising risks by clear thinking. (shrink)

Warren Samuels maintains that every society has a constant amount of coercion and order, which vary only in terms of who gains and who loses, because every society has a government that establishes property rights. In making these arguments, Samuels exaggerates the extent to which governmental decisions predetermine the workings of a market society, and he fails to recognize that, with regard to the attainment of specific socioeconomic outcomes, governmental stipulation of private property rights differs fundamentally from governmental command and (...) control. (shrink)

This article questions whether many are misled by current case studies. Three broad types of style of case study are described. A stark style, based on medical case studies, a fictionalised style in reaction, and a personal statement made in discussion groups by an original protagonist. Only the second type fits Pattison's category. Language remains an important issue, but to be examined as the case is lived in discussion rather than as a potentially reductionist study of the case as text.

The following case was presented by a trainee general practitioner, working in inner London, to her release course for discussion. It is told, as it was presented, in the immediate aftermath of the events described. The names and some of the details have been altered.

Martin J. Sklar's The Corporate Reconstruction of American Capitalism, a revisionist account of the early antitrust laws in particular and the political economy of the Progressive Era in general, offers a wealth of detailed research and a particularly valuable reinterpretation of the jurisprudence of antitrust law during the period 1890?1911. A neo?Marxist framework of analysis, however, detracts from the work and causes Sklar to misread the valuable evidence he has compiled. By misinterpreting standard economic models of market structure, he incorrectly (...) concludes that the large corporations could?regulate? the market if the government did not do so. By viewing the political economy as a comprehensively and tightly integrated structure of technologies, property rights, political powers, ideology, and social classes, he fails to give due weight to the diversity of influential interests contending within the political economy, especially within the?capitalist class,? and shaping its historical transformation. (shrink)

Sport and Religion by Shirl J. Hoffman, Editor (Champaign, IL: Human Kinetics, 1992) Religion and Sport: The Meeting of Sacred and Profane by Charles S. Prebish, Editor (Westport, CT: Greenwood Press, 1993).

This chapter contains sections titled: The Clinical Encounter Medical Paternalism Re‐examined Ethical Frameworks The Temptation to Deceive Different Forms of Deception Communicating Outside Medicine Character, Context, and Care References Further reading.

Book reviewed in this article: In That Case: Medical Ethics in Everyday Practice. By Alastair Campbell and Roger Higgs. Medical Genetics Casebook: A Clinical Introduction to Medical Ethics Systems Theory. By Colleen D. Clements. Cases in Bioethics from the Hastings Center Report. Edited by Carol Levine and Robert M. Veatch. Hastings‐on‐Hudson.

A patient with AIDS dementia was confronted and compulsorily prevented from flying out of the country before being admitted against his will to hospital. While finding this on balance justified in the circumstances the commentators raise moral questions about the levels of care in general practice and within the couple's own relationships.