Decisions about how and where they deliver their baby are extremely important to pregnant women. There are very strong ethical norms that women’s autonomy should be respected, and that plans around birth should be personalised. However, there appear to be profound challenges in practice to respecting women’s choices in pregnancy and labour. Choices carry risks and consequences—to the woman and her child; also potentially to her caregivers and to other women.What does it mean for women’s autonomy to be respected in (...) obstetrics? How should health professionals respond to refusals of treatment or requests for care outside normal guidelines? What are the ethical limits to autonomy? In this clinical ethics round table, service users, midwives, obstetricians, philosophers and ethicists respond to two hypothetical cases drawn from real-life scenarios. (shrink)

Erving Goffman’s “Asylums” is a key text in the development of contemporary, community-orientated mental health practice. It has survived as a trenchant critique of the asylum as total institution, and its publication in 1961 in book form marked a further stage in the discrediting of the asylum model of mental health care. In this paper, some responses from a range of disciplines to this text, 50 years on, are presented. A consultant psychiatrist with a special interest in cultural psychiatry and (...) mental health legislation, two collaborating psychotherapists in adult and forensic mental health, a philosopher, and a recent medical graduate, present their varying responses to the text. The editors present these with the hope of encouraging further dialogue and debate from service users, carers, clinicians, and academics and researchers across a range of disciplines. (shrink)

PurposeMedical humanities is a field which implies collaborative work across disciplines although the degree to which this actually occurs is unknown. Our purpose was to determine the degree of joint work in medical humanities through analysis of authorship and acknowledgements in the two main medical humanities journals.MethodsObservational survey of authorship. We studied authorship data in all papers published in the two major general medical humanities journals between 2009 and 2018.ResultsTwo-thirds of papers had single authors, of whom a majority declared a (...) single disciplinary affiliation. The titles of 60.8% of papers explicitly suggested collaborative content of which 19.9% had multiple authors from more than one discipline ; of the remainder, almost half had a single, single-disciplinary author. One-third of papers referenced one or more people in the acknowledgements. Among papers whose titles suggested humanities or medical content only, authorship lists of 10.2% and 17.9% respectively demonstrated collaborative scholarship.ConclusionsDespite considerable involvement from both humanities and medical practitioners, there is still substantial scope for enhanced emphasis on collaborative seminars and exchanges in the medical humanities and editorial policies to promote transparency of the nature of collaborative work among disciplines. Journal editors and editorial boards should reflect on the opportunity to promote enhanced visibility of joint work in scholarship in the medical humanities through reflection and review of current editorial policies. (shrink)