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Instituteof MedicalpRFSIDEN'ISir Douglas BlackVICE PRlESIt)FNTSprofessor G R Dunstanprofessor Sir Raymond HoffenbergMlr R SellsProfessor R B WelbournGOVERNIN'G BODYProfessor M BrazierBrendan Callaghan SJAllan ChappellDr Coln CurrieDr Donald EvansProfessor Raanan Gillon(Editor, Jourinal of Medical Ethics)Professor Roger HiggsDr Tony HopeProfessor Bryan JennettProfessor D MortonProfessor Thomas Oppe(Chairmian1)Professor Richard West(GealL ral Secretar)Director of Research and ScottishDirectorDr Kenneth BoydResearch FellowDr Hazel McHaffieIME Amulree FellowThe Very Reverend Edward ShotterDean of RochesterHonorary Research AssociatesDr Andrewk FraserDr Jane SmithUrsula GallagherAnn Lloyd, Techimical Editor, Journnal ofMedical Ethic.sMaureen Bannatvne, Edi'torial Assi.stantEthicsThe Institute of Medical Ethics is an independent, non-partisanorganisation for the multidisciplinary study of medico-moral issuesraised by the practice of medicine, and concerned with research, education and information. It is financed by grants and donations frompublic and private sources.The institute aims to help impro the quality of both professionaland public discussion of medicc ioral questions; to promote thestudy of medical ethics; to promote high academic standards for thisever developing subject; to encourage a multidisciplinary approach todiscussion of the consequences of cliniel- practice; to stimulateresearch into specific problems, and to rc ,nain non-partisan andindependent of all interest groups and lobbies.eInstitute reports include: The Ethics of Resource Allocation inl HealthCare by Kenneth Boyd, and Dile,nmniias of Dyinig by Ian Thompson,Edinburgh University Press (both 1979); Medical Research zwithChildreni: Ethics, Law anzd P'ractice by Richard Nicholson, and Lives in1the Balanzce: the Ethics of Using Aniznals inl Biomitedical Vedical Researchby Jane Smith and Kenneth Boyd. Oxford University Press (1986 and1991); Life Before Bir-th by Kenneth Boyd, Brendan Callaghan andEdward Shotter. SPCK (1986); Teaching anid Learning Nuvrsing Ethicsby Ursula Gallagher and Kenneth Boyd, Scutari (1991) and SorbonaMlilan (I1993); The Ponid Report onl the Teachling of AMedical Ethics editedby Kenneth Boyd, and 777e Care of Patients with HIVanid AIDS: ASumere of NYurse Education in the UIK, by Hazel MNlcHaffie, publisheddirectly for the institute (1987 and 1994); Life, Death anid Decisionis:Doctors and Nuiirses Reflect oni Neoniatal Prractice, by Hazel M'vicHaffie andPeter Fowlie, published by Hochland and Hochland (1996).Shorter institute reports include: Assisted Death, Lanicet, 1990; AIDS,ethics and clinical trials, Briti'sh. Mlediccal Jou-rnal, 1992; AIDS and theethics of medical care and treatment, Qutar-terlv Journial of Mledicine,1992; Advance directives: partnership and practicalities, BritishlJ7ournal of Genieral Practice, 1 993; Implications of HIV infection andAIDS for medical education, Medical Edutcationi, 1 994; and Prolonginglife and allowing death: infants, Jou0rn1al of Medical Ethlics. 1995.The institute derives from the Iondon NMedical Group, a studentfor the study of ethical issues raised by the practice of medicinewhich, beginning in 1963, arranged a comprehensive programme oflectures and symposia on such issues. Similar groups associated withthe institute are now established in university teaching hospitalsthroughout the UK.groupP'rofessor Richard WestGeneral Secretary, 1IMlEMedical Postgraduate DepartmentUniversity of BristolFrenchay Hospital, FrenchayPark Road, Bristol BS16 ILEDr Kenneth BoydDirector of Research andScottish Director, ]MEDepartment of0ledicineRoyal Infirmarv of EdinburghLauriston Place, Edinburgh El13 9Y'WPublished by the BMIJ Publishing Group on behalf of the Institute of Medical Ethics and the lBritish vMedical Association.Typesetting by Bedford Typesetters, Bedford. Printed in Great Britain on Acid-Free paper by Derrv & Son Ltd, Nottingham.The Institute of Medical Ethics is a registered charity, No 261876.SCiond .lass postage paid. Rahlvaiv N J lostmna ticr senid aidircss. Lh.rnles ao:Journal of Medical Ethics c/i .Miercurn Air1reighlt Intrnationial Lt 1inc. 2i23 RanSinlcph AvOlLe. Avenci. NJ 07/0o1, USA
The journal of the Institute of Medical EthicsThe funialofeMdical Ethics was established in 975, with a multidisciplinary editorial board, to promote the stud of contemporary medicomoral problems. The editorial board has as its aims the encouragement of a high academic standard for this ever-developing subject and theenhancement of professional and public discussion. The journal is published six times a vear and includes papers on all aspects of health careethics, analyses ethical concepts and thcories and features case conferences and comment on clinical practice. Intermittent series focus onthe Teaching of medical ethics; on the medico-moral problems directly experienced by health care workers (At the coalface); on thepursuit of arguments prompted by papers in the journal (Debate); on nmedical ethics in literaturc (Medical ethics and literature); and onbriefly argued often unorthodox opinions related to medical ethics (Point of view). The journal also contains book reviews and letters. Forsubmissions, see Notice to contributors.Professor H E Emson, pathologist, Royal University Hospital,Saskatoon, CanadaEL ITOR:Dr Calliope CS Farsides, philosopher, University of Keele, UKProfessor Raanan Gillon, general practitioner and philosopher,Ms 7ina Garanis-Papadotos, medical lavwer, Athens School ofImperial College, London UniversityPublic Health, GreeceCO NSUiLTING FDITORS:Dr Shimon Glick, physician, Ben GJurion Uniiversity of the Negev, IsraelSir Douglas Black, phvsician, Manchestcr Univcrsitv, UKProfessor Zaki Hasan, physician, Vice Chancellor, Baqai University,Professor Robin Downie, moral philosopher, Glasgow University, UKKarachi, Pakistan(-I iAiR.\iAN,ORiAI B(OARi):Dr Neville Hicks, medical sociologist, University of Adelaide, AustraliaProfessor Ihomas Oppe, paediatrician. St Mary's Hospital MvcdicalMsJenniferjackson, philosopher. Director, Centre for Business andSchool. I ondon UKProfessional Ethics, University of Leeds, UKiiITORIAI ASSOCIJATEF:Professor Albert Jonsen, ethicist and historian, University ofDr Tony Hope, psychiatrist, Reader in Medicine and leader, OxfordWashington, USAP'ractice Skills P-roject, Oxford University, UKProfessor Ian Kennedy, President, Centre for Medical Law andC ASE ( ONFEREiNC( ASSO(CIATE :Ethics, King's College, London, UKDr Brian Hurwitz, Senior Lecturer, t)epartment of General Practice,Professor Rihito Kimura, lawyer, Waseda University, JapanDr Paula Kokkonen, lawyer, Director of the National Board ofImperial Collcgc School of Medicine at St Mary's, london, UKDr Susan Bewley, Director of Obstretrics, St Ihomas's I lospital,Medicolegal Affairs, Helsinki, FinlandLIondon, UKDr Simzon Lundy, general practitioner, London, UKDr Kenneth Boyd, historian, chaplain, Universitv of Edinburgh, UKProfessor Ruth Macklin, philosopher and ethicist, Albert EinsteinProfessor Margaret Brazier, medical lawver, Manchester University,College of Medicine, New York, USAUKDr AMaureen MacMillan, nurse, Edinburgh, UKProfessor Anthony Culyer, ProfcssoTr of Econoiics, University of Professor Malcolm .4dacnaughton, obsterrician/gynaecologist,York, UKGlasgowv University, UKDr Donna Dickenson, mcdical ethicist and philosopher, ImperialProfessor Maurizio M0on, philosopher, Consulta di Bioctica diCollege, London Universitv, UKMilano, ItalyProfessorJohn Haldane, philosopher. Universitv of St Andrews, UKProfessor Ben Osuntokun, physician, University of Ibadan, NigeriaDr .Naomi Pfeffer, medical sociologist, University of North London, UKProfessorJohn Hartis, philosopher, Manchester Universitvy UKDr Sashka Popova, social scientist, Department of Social Medicine andProfessor Roger Higgs, general practitionier, anid Head of Departmentof General Practice, King's College. London, UKPublic Health, Sofia, BulgariaRt Hon Sir Patrick N'airne, Chair of the Nuffield Council on BioethicsProfessor Qui Ren-Zong, philosopher, Institute of Philosophv,RabbiJulia .Neuberger, Chair, Camden Community Health Council.Beijing, ChinaDr Janet Radcliffe-Richards, philosopher, Opcn University, MiltonLondon, UKDr Allyson Pollock, pciblic health physician, St Georgc's Hospital.Keynes, UKLondon, UKProfessor Pinit Ratanakul, physician, philosopher, MahidolProfessor Aluin Pomnpidou, pathologist, mcmber of European parliaUniversitv, Bangkok, Thailandmenit. FranceDr Stella Reiter-Theil, phvsician, Akademie fur Ethik in der Medizin,Dr Octavi Quintana, Chairman, Council of European SteeringGeorg-August-Uniiversitat, Goettingen, GermanvCommiiiiittee for Bioethics, .Madrid, SpainProfessor Povl Riis, phvsician, Herlev Universitv, Chair of NationalThe Very Reverend Edward Shotter, Dean ,f Rochester, Institute ofEthics Cotnmittee. Denmark.Medical Ethics Amulree Fellow, UKProfessor Daniel Serrao, physician. University of Porto MedicalProfessor Bob Williamson, moilecular biochemist, Murdoch Institute,School, PortugalRoval Children's Hospital, Melbourne, AustraliaMr Robert Sells, transplant surgeon, Dircctor, Renal Transplant Unit,Royal Liverpool University Hospital, UKProfessor Gamal Serour, obstetrician/gynaceologist, InternationalDr Richard Smith, editor, B"iti/, ,di.a! 7ouoia/, UKIslamicCenter for Population Studies and Research, Cairo, EgyptProfessor Richard WE'est, postgraduate medical dean, BristolProfessor WShannon, general practitioner, Royal College of SurgeonsUniversitv, UK, general secretary, Inistitutc of Medical Ethics, UKofIrelandMedical School, Dublin, IrelandAnn Lloyd, Technical Editor, J.MEProfessor Mark Siegler, phvsician and ethicist, University of ChicagoMaureen Bannatyne, Editorial Assistant, JMEHospitals, Illinois, USAProfessor Jack Stanley, philosopher, Lawrence Universitv, Appleton,Wisconsin, USAEditorial BoardEditorial Advisory BoardProfessor Kare Berg, phvsician, Chairman, Institute of MedicalGenetic', Universitv oi Oslo, NonravDr Bela Blasszauer, medical la%vver, Medical Unix'crsitv of Pecs,HungarvDr MMudr Martin Bojar. neurologist, Charles University, Prague,Czech RcpubltcJuidge CGristian Byk, medical lawyer and miigistratc, IParis, FranceProfessor Alastair Canipbell, theologian, IProfessor of Ethics inM\4edicine, Universitv of Bristol. UKProfessor rernando da Roch'a, philosopher. Universidade Federal doRio Grande do Sul, BrazilDr Dolores Dooley, philosopher, University College. C ork, IrelandJulie Stone, lawver and lecturer, Birmingham Medical School. UKDr Per Sundstrom, freelance writer in medical ethics and philosophy,SwedenProfessorJuan Carlos Tealdi, phvsician and philosopher, FundacionMainetti, Buenos Aires. ArgentinaProfessor Henk Ten Have, physician and philosopher. CatholicUniversity of Nitmegen, the NetherlandsProfessor Dr Guido Van Steendam, philosopher, InternationalI;orum for Biophilosophv, BelgiumProfessor Francisco Vilardell, phvsician and president of CIOMS,.ifsBarcelona, SpainProfessor Jenifer WVilson-Barnett, nurse, Head of Department ofNursing Studies, King's College London, UKNotice to subscribers'1'he ouroail of AI.didal Ethics is published six titimes a vear. 'l'he annual subscription ratc is 1 18 for institutions and 82.00 for personalsubscribers t'or all countries. 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376 Why causing death is not necessarily morally equivalent to allowing to die - a response to Fergusonought to be withheld or withdrawn. Her arguments her conclusions were accepted and enshrined in lawwhen combined would then inevitably lead to com- there would be far-reaching moral and legal effectspulsory non-voluntary, and indeed involuntary, on society which the vast majority of people wouldeuthanasia of such patients. Furthermore, since in consider disastrous.law others, besides doctors, have a duty of caretowards patients, it may follow that if doctors have a Fiona Randall, FRCP, is Consultant in Palliativelegal obligation to end the patient's life, so might Medicine, Christchurch Hospital, Fairmile, Christanyone else who has a duty of care, for example church, Dorset.nurses or relatives. I would suggest that even themost staunch proponents of euthanasia would notsupport this view, which would horrify the public Referencesand health care professionals alike.1 Ferguson PR. Causing death or allowing to die?I have argued that Dr Ferguson's premises areDevelopments in the law. Journal of Medical Ethics 1997;either unconvincing or clearly false. Furthermore, if6: 368-72.News and notesEthics and palliative careAn advanced European Bioethics Course on ethics andpalliative care will be held from 2-4 April 1998, inNijmegen, the Netherlands. Specialists from differentcountries will discuss ethical aspects of palliative care.Subjects: Evolution of palliative care; Ethics and painmanagement; Limits of palliative care; Futility ofmedical treatment; Palliative care and euthanasia.Lecturers: Dame C Saunders (UK), Z Zylicz(Netherlands), S Huseb0 (Norway), HAMJ ten Have(Netherlands), W Dekkers (Netherlands), B Gordijn(Netherlands). Language: English.For more information: Dr B Gordijn, CatholicUniversity of Nijmegen, 232 Dept of Ethics,Philosophy and History of Medicine, PO Box9101, 6500 HB Nijmegen, the Netherlands.Tel: [31] 24-3615320. Fax: [31] 24-3540254.E-mail: b.gordijn@efg.kun.nl Internet site: http://www.azn.nl/fmw/maatschp/pallial.htm
378 At the coalface - medical ethics in practice: First, do no harmWhile debating the risks and benefits of continued study involvement with Mrs W and herfamily, Mrs W related that her right leg now couldnot move at all. We immediately terminated MrsW's participation in the study on her third day ofthe trial. The spinal catheter was removed, theblind broken and a neurosurgeon urgently consulted. Mrs W was receiving active medicationthrough her catheter which caused most of hersymptoms. She also was found to have a metastasisof her cancer impinging on her spine, which causedthe right leg paralysis. Emergency radiation treatments palliated this problem.We stopped participating in this study becausethe side effects of the drug overlap the potentialcomplications of a spinal catheter. The possibility ofascribing symptoms to a drug (that may not evenhave been administered to a patient) and overlooking an early warning sign of a potentially devastatingcondition was very real and disconcerting to us.We feel that our patients deserve a physician whohas all the available information. Blinding the physician for research purposes diminishes the ability tomake the best medical judgments on our patients'behalf. Mrs W's case demonstrates that the role ofphysician and clinical investigator can pose a conflictand when that occurs the principle of primun nonnocere can be unduly stressed.Scott Groudine, MD, is Assistant IPofessor ofAnesthesiology and Surgery, Albany Medical College,Albany, New York, USA. Philip D Lumb, MBBS, isProfessor and Chairman of Anesthesiology at the samecollege.News and notesJournal of Medical Ethics - http://www.jmedethics.comVisitors to the world wide web can now accessthe Journal of Medical Ethicseither throughthe BMJ Publishing Group's home page(http://www.bmjpg.com) or directly by using itsindividual URL (http://www.jmedethics.com). Therethey will find the following:* Current contents list for the journal* Contents lists of previous issues* Members of the editorial board* Subscribers' information* Instructions for authors* Details of reprint services.A hotlink gives access to:* BMJ Publishing Group home page* British Medical Association website* Online books catalogue* BMJ Publishing Group booksThe web site is at a preliminary stage and there areplans to develop it into a more sophisticated site.Suggestions from visitors about features they wouldlike to see are welcomed. They can be left via theopening page of the BMJ Publishing Group site or,alternatively, via the journal page, through "about thissite".
Book reviews 391own experience that "patients whorequest euthanasia almost invariablychange their minds" (page 155).Whilst he accepts that his approachcan be described as piecemeal, heconcludes that taken together his individual concerns about euthanasia addup to an overwhelming case againstlegislation. Jennett, considering thevery specific problem of patients inpersistent vegetative state, is largelyconcerned with developing a sensibleapproach to the treatment, and nontreatment, of such patients. Jennettaccepts and discusses the great difficulty in finding ethical justificationsfor the decision not to continue treatment in cases where there is noadvance directive. He does, however,provide a lot of practical informationabout such decisions, and as such provides answers to many of the questions often posed in the debate.Jennett's chapter is followed by "Acase for sometimes tube-feedingpatients in persistent vegetative state"by Professor Joseph Boyle, a philosopher. Like Boyd earlier, he concludesthat the circumstances of the individual case will be the decisive consideration. However, unusually, he goesfurther than most and accepts that thefactor of cost may also be morallydecisive in some cases.The final five chapters are allwritten by those with some legal training, although that is not to say thatthey speak from a universally legalperspective. Professor Dieter Giesenprovides a comparative overview ofthe laws and experience of a variety ofdifferent jurisdictions. He reflects thatthe lesson to learn is the importance ofthe law conforming to fundamentalprinciples of patient autonomy andwhat he calls "personality interests".Yale Kamisar considers the variousrights-based arguments rehearsed inthe USA. He affirms the importanceof precise definition, then illustratesthe difficulties in achieving such precision and provides an illuminatingdiscussion of the constitutional arguments for and against euthanasia andassisted suicide.John Keown's chapter describingthe experience of euthanasia in theNetherlands is a vivid reminder of theimportance of practical considerationsin any consideration of the options forreform. His discussion illustrates thecentral difficulties highlighted bycommentators earlier in the book.The difficulty of defining what onemeans by euthanasia underlies hisanalysis of the data available in theNetherlands. The difficulty of distinguishing between what doctors doevery day and do not consider to beeuthanasia - for example, withholdingtreatment and giving pain relief inpotentially fatal doses - and whatrequires regulation, is another factorwhich impacts upon the interpretationof the statistical information available.The difficulty of defining with any realprecision the circumstances in whicheuthanasia may be permissible, and ofpolicing any guidance in this regardare also illustrated by the experiencein the Netherlands. The expandedmeaning given to terms such as "intolerable suffering" and "last resort" inthe Netherlands must be taken onboard by those proposing a change inthe law in the United Kingdom. Thedifficulty with his argument that thissurely reflects the real danger of theslippery slope lies in our limitedunderstanding of the overlap betweenwhat happens in the Netherlands andwhat happens in practice in theUnited Kingdom, where doctors areallowed to withhold medical treatment if this is consistent with theirclinical judgment, and to take stepswhich lead to the cessation of lifeunder the "double-effect" doctrine.Stuart Hornett's chapter onadvance directives is a useful description and analysis of English law in thisarea. Anthony Fisher's concludingchapter, "Theological aspects ofeuthanasia" provides some muchneeded balance to the secular judgments frequently found in England,for example in the speeches of theLaw Lords in Bland.Overall, the essays show thatalthough people often considereuthanasia from different perspectives, and reach different conclusions,they will almost always revert to consistent themes to premise their discussion. The difficulty of definition, thedistinction between what happensnow and what would happen ifeuthanasia were lawful, the need totake account of practical consequences, and the impossibility ofignoring the particular circumstancesof each case, are shown to be real andrelevant concerns in each and everyessay. The book is an invaluable contribution to the debate - both for thevalue of the individual contributions,and for the overview which it affordsby placing them all in one volume.References1 Airedale NHS Trust v Bland[1993] AC 789.KRISTINA STERNBarister, 39 Essex Street, LondonBooks: information and ordersIf you wish to order or require furtherinformation regarding the titlesreviewed here, please write to ortelephone the BMJ Bookshop, POBox 295, London WCIH 9JR. Tel:0171 383 6244. Fax: 0171 383 6662.Books are supplied post free in theUK and for BFPO addresses.Overseas customers should add 15per cent for postage and packing.Payment can be made by cheque insterling drawn on a UK bank or bycredit card (Mastercard, Visa, orAmerican Express, stating card number, expiry date, and full name (Theprice and availability are occasionallysubject to revision by the publishers).
J7ournal of Medical Ethics, 1997; 23: 393Index by subject matter (thematic review)Journal of Medical Ethics, volume 23, 1997Editor's NoteThis combined index and thematic review was introduced in the hope that it would be more useful toreaders than the old system. In the first part, papersand book reviews are classified using the AmericanNational Reference Center for Bioethics Literature1.1: Ethics: Philosophical ethics1997 VOLUME 23/5Health care, human worth and the limits ofthe particular, 310-314Cherry, Christopher1.3: Ethics: Applied and professionalethics: General1997 VOLUME 23/1Authority, autonomy, responsiblity andauthorisation: with specific reference toadolescent mental health practice, 26-31Sutton, Adrian1997 VOLUME 23/4The relationship between clinical audit andethics, 250-253Kinn, Sue1997 VOLUME 23/5The medical student and the suicidalpatient, 277-281Barrett, Nicholas A1.3.2: Ethics: Applied and professionalethics: Business1997 VOLUME 23/5Guest editorial: Corporate tyranny, 269-270Black, Sir Douglas1.3.7: Ethics: Applied and professionalethics: Journalism1997 VOLUME 23/6Questionable ethics - whistle-blowing ortale-telling? 382-383Chambers, Timothy1.3.9: Ethics: Applied and professionalethics: Scientific research1997 VOLUME 23/3The views of members of Local ResearchLibrary Classification Scheme (the Kennedysystem), which is printed on page 402. In the secondpart authors, reviewers, papers and book reviews arearranged alphabetically, with their Kennedy classification following.Ethics Committees, researchers andmembers of the public towards the rolesand functions of LRECs, 186-190Kent, GerryHope, TonyEthics education for medical houseofficers: long-term improvement inknowledge and confidence,Sulmasy, Daniel P and Marx, Eric S2.1: Bioethics: General1997 VOLUME 23/2Guest editorial: Are attitudes towardsbioethics entering a new era?, 69-70Lenoir, Noelle1997 VOLUME 23/3Guest editorial: Petty corruption in healthcare, 133-134Blasszauer, Bela1997 VOLUME 23/3Requests for "inappropriate" treatmentbased on religious beliefs, 142-147Orr, Robert D and Genesen, Leigh B1997 VOLUME 23/5May we practise endotracheal intubationon the newly dead?, 289-2941997 VOLUME 23/5Teaching medical ethics: Teaching ethicsusing small-group, problem-basedlearning, 315-318Tysinger, James W, Klonis, Leah K,Sadler, John Z and Wagner, James W4.1.1: Philosophy of medicine andhealth: Philosophy of the healthprofessions: General1997 VOLUME 23/1Imagination in practice, 45-50Scott, P Anne1997 VOLUME 23/2Changing priorities in residential medicaland social services, 77-81Greaves, DavidArdagh, Michael1997 VOLUME 23/6Editorial: "Futility" - too ambiguous andpejorative a term, 339-340Gillon, RaananMarginally effective medical care: ethicalanalysis of issues in cardiopulmonaryresuscitation (CPR), 361-367Hilberman, Mark, Kutner, Jean, Parsons,Debra and Murphy, Donald J2.3: Bioethics: Education/programmes1997 VOLUME 23/2Ethics and the GMC Core Curriculum: asurvey of resources in UK medical schools,82-87Fulford, KWM, Yates, Anne and4.1.2: Philosophy of medicine andhealth: Philosophy of medicine1997 VOLUME 23/2Changing priorities in residential medicaland social services, 77-81Greaves, David1997 VOLUME 23/3Medical futility and the social context,148-153Halliday, Robert1997 VOLUME 23/4Partial and impartial ethical reasoning inhealth care professionals, 226-232Rickard, Maurice, Singer, Peter andKuhse, Helga
Journal of Medical Ethics, 1997; 23: 3949.6: Health care: Quality of healthcare/ethics committees4.1.3: Philosophy of medicine andhealth: Philosophy of the healthprofessions: Philosophy of nursing8.3.3: Professional-patientrelationship:Informed consent:Thirdparty consent/incompetents1997 VOLUME 23/4Partial and impartial ethical reasoning inhealth care professionals, 226-232Rickard, Maurice, Singer, Peter andKuhse, Helga1997 VOLUME 23/4Ethics and law in the field of medical carefor the elderly in France, 233-238Gromb, Sophie, Manciet, Gerard andDescamps, Arnaud1997 VOLUME 23/4Editorial: Clinical ethics committees - prosand cons, 203-204Paediatrics at the cutting edge: do weneed clinical ethics committees?, 245-249Larcher, VF, Lask B, and McCarthy JM6: Codes of professional ethics8.3.4: Professional-patientrelationship: Informed consent: Rightto refuse treatment1997 VOLUME 23/5Guest editorial: Corporate tyranny, 269-270Black, Sir Douglas1997 VOLUME 23/4An analysis of CPR decision-making byelderly patients, 207-212Sayers, Gwen M, Schofield, Irene andAziz, Michael1997 VOLUME 23/5Teaching medical ethics: Teaching ethicsusing small-group, problem-basedlearning, 315-318Tysinger, James W, Klonis, Leah K,Sadler, John Z and Wagner, James W1997 VOLUME 23/2Kindness, prescribed and natural, inmedicine, 116-118Pickering, William G1997 VOLUME 23/4The new Italian code of medical ethics,239-244Fineschi, Vittorio, Turillazzi, Emanuelaand Cateni, Cecilia7.2: Sociology of medicine: Medicaleducation1997 VOLUME 23/5Teaching mnedical ethics: Teaching ethicsusing small-group, problem-basedlearning, 315-318Tysinger, James W, Klonis, Leah K,Sadler, John Z and Wagner, James W8.1: Professional-patient relationship:General1997 VOLUME 23/4Existential autonomy: why patients shouldmake their own choices, 221-225Madder, Hilary1997 VOLUME 23/5Teaching medical ethics: Teaching ethicsusing small-group, problem-basedlearning, 315-318Tysinger, James W, Klonis, Leah K,Sadler, John Z and Wagner, James W8.2: Professional-patient relationship:Truth-telling1997 VOLUME 23/2Should doctors inform terminally illpatients? The opinions of nationals anddoctors in the United Arab Emirates,101-107Harrison, Ann, Al-Saadi, Ahmed MH,Al-Kaabi, Ali SO, Al-Kaabi, MohammedRS, Al-Bedwawi, Saif SM, al-Kaabi,Saif OM, Al-Neaimi, Salem BS8.4: Professional-patient relationship:Confidentiality12.1: Abortion: General1997 VOLUME 23/5The medical student and the suicidalpatient, 277-281Barrett, Nicholas A1997 VOLUME 23/1The case of Medea - a view of fetalmaternal conflict, 19-25Reid, Matthew C and Gillett, Grant9.1: Health care: General12.3: Abortion: Moral and religiousaspects1997 VOLUME 23/4Patients' rights in England and the UnitedStates of America: The Patient's Charterand the New Jersey Patient Bill of Rights:a comparison, 213-220Wilson Silver, Melanie H1997 VOLUME 23/3Bodies, rights and abortion, 176-180McLachlan, Hugh V12.4.4: Abortion: Legal aspects: Bills,laws and cases9.2: Health care: Right to health care1997 VOLUME 23/2Morality, consumerism and the internalmarket in health care, 71-76Sorell, Tom9.3: Health care: Cost of health care1997 VOLUME 23/2Morality, consumerism and the internalmarket in health care, 71-76Sorell, Tom9.4: Health care: Allocation of healthcare resources1997 VOLUME 23/2Morality, consumerism and the internalmarket in health care, 71-76Sorell, Tom8.3.1: Professional-patientrelationship: Informed consent:General1997 VOLUME 23/2Changing priorities in residential medicaland social services, 77-81Greaves, David1997 VOLUME 23/5Ethical issues in long term psychiatricmanagement, 300-304Dickenson, Donna9.5.1: Health care: Health careprogrammes for specificdiseases/groups: General1997 VOLUME 23/5Should informed consent be based onrational beliefs?, 282-288Savulescu, Julian a
St Mary's Hospital Mvcdical School. I ondon UK iiITORIAI ASSOCIJATEF: Dr Tony Hope, psychiatrist, Reader in Medicine and leader, Oxford P'ractice Skills P-roject, Oxford University, UK CASE ( ONFEREiNC( ASSO(CIATE: DrBrian Hurwitz, Senior Lecturer, t)epartment ofGeneral Practice, Imperial Collcgc School of Medicine at St Mary's, london, UK
Independent Personal Pronouns Personal Pronouns in Hebrew Person, Gender, Number Singular Person, Gender, Number Plural 3ms (he, it) א ִוה 3mp (they) Sֵה ,הַָּ֫ ֵה 3fs (she, it) א O ה 3fp (they) Uֵה , הַָּ֫ ֵה 2ms (you) הָּ תַא2mp (you all) Sֶּ תַא 2fs (you) ְ תַא 2fp (you
akuntansi musyarakah (sak no 106) Ayat tentang Musyarakah (Q.S. 39; 29) لًََّز ãَ åِاَ óِ îَخظَْ ó Þَْ ë Þٍجُزَِ ß ا äًَّ àَط لًَّجُرَ íَ åَ îظُِ Ûاَش
Collectively make tawbah to Allāh S so that you may acquire falāḥ [of this world and the Hereafter]. (24:31) The one who repents also becomes the beloved of Allāh S, Âَْ Èِﺑاﻮَّﺘﻟاَّﺐُّ ßُِ çﻪَّٰﻠﻟانَّاِ Verily, Allāh S loves those who are most repenting. (2:22
Unit-1: Introduction and Classification of algae (04L) i) Prokaryotic and Eukaryotic algae ii) Classification of algae according to F. E. Fritsch (1945), G.W. Prescott and Parker (1982)
ANSI A300 Part 4 ( American National Standards Institute, Standard for Lightning protection Systems For Trees ) recommends designing the earth (ground) termination based on a visual inspection of the soil and its moisture content. This is not possible as water is an insulator not a conductor; it is the dissolved salts in the water that give it its conductive properties. These salts are not .
BasiC Counselling skills Let’s get down to basics. The word ‘basic’, when used in conjunction with counselling skills, implies a repertoire of central counselling skills on which you can base your helping practice. Another related meaning of the term ‘basic’ is that of being fundamental or primary rather than advanced. The quality of the helper–client relationship is essential to .
iv Buku Panduan Pendidikan FIK UI TIM PENYUSUN Pengarah Dekan Fakultas Ilmu Keperawatan UI Penyusun Buku Ketua: Agus Setiawan, SKp. MN, DN Kontributor: 1. Dr. Enie Novieastari, SKp.
Media yang digunakan untuk menyampaikan informasi adalah buku saku. Menurut Rumelan (2014), buku saku adalah buku dengan ukuran kecil, ringan, dan bisa disimpan disaku. Informasi dalam buku saku dapat dimanfaatkan oleh masyarakat agar bijak dalam memilih bahan-bahan alami dalam perawatan kulit. 1.2 Rumusan Masalah . Berdasarkan latar belakang masalah diatas dapat diambil rumusan masalah .
