Originally published in 1970 this title commemorates the men and ideas that started, inspired and established a pioneer institution in British psychiatry. Based on the impetus of Freudian and related innovations after the First World War, the Tavistock Clinic offered treatment, training and research facilities in the field of neurosis, child guidance and later on group relations. Dr Dicks, who had been associated for nearly forty years with the work and personalities that helped to develop the Tavistock venture, describes the (...) struggles and capacity for survival of the clinic. He shows how, belonging neither to the older classical psychiatry nor to orthodox psychoanalysis, and suspect to both, the Clinic nevertheless became increasingly used by the rest of the profession as a psychotherapeutic resource. Dr Dicks describes the influence of the Tavistock on the medical, psychological and social work scene both before and after the Second World War, and assesses its achievements as a centre of psycho- and socio-dynamic thinking. The Tavistock is shown as a pioneer _sui generis_, launching psychosomatic research and initiating the exciting ventures in social psychiatry associated with the Army in the Second World War. As the Tavistock was the outcome of work with shell-shock victims in the first war, so its offspring, the Institute of Human Relations, was the natural continuation of the military effort in man-management, morale and group dynamic studies. The book includes an account of the inter-relationship between the Clinic, now part of the National Health Service, and the Institute, a private corporation. Still going strong as part of the Tavistock and Portman NHS Foundation Trust today this is an opportunity to revisit its early history. (shrink)

At the beginning of the twentieth century, poliomyelitis presented a scientific and medical challenge of a complexity similar to that of AIDS now. Research on polio, mainly in the US, gradually became focussed to solving basic questions, but was held up by the lack of suitable laboratory techniques. The financing of the research and the wide range of basic topics funded were the model for later medical science. The problem of polio, at least in the wealthier temperate countries, has been (...) solved by the use of vaccines. Many fundamental questions about the mechanism of the disease remained unsolved and this lack of knowledge has contributed to many unfortunate accidents. The history of polio has many lessons for AIDS researchers. (shrink)

Death of motor neurones following invasion of the central nervous system by poliovirus may result in paralysis of specific muscles. Virulence may be tested by injection into monkeys by routes which bypass natural infection. Transmissibility is also very important, but cannot be measured, only inferred. An infection may lead to immunity or paralysis. In epidemics, the highest incidence among children 0-2 years was 2% and among those over 10 years was 25%: these figures fit a model of genetic susceptibility of (...) homozygotes and heterozygotes with phenotypic susceptibility increasing with age. Hypogamma-globulinemics, some neonates and pregnant women are more susceptible than others. Intra-muscular injections may increase the risk of paralysis. Strenuous exercise and IM injections given when poliovirus has already reached the spinal cord can increase the severity of paralysis or convert a non-paralytic attack to paralysis. Although vaccines reduced polio in temperate countries, polio was thought to be no problem in the tropics. Since 1977 polio has been recognised as a massive problem in the third world: because it affects babies and very young children, it is properly infantile paralysis. (shrink)

Coggon’s remarks on a previous paper on active and passive euthanasia elicit a clarification and an elaboration of the argument in support of the claim that there is a moral difference between killing and letting die. The relevant moral duties are different in nature, strength and content. Moreover, not all people who are involved in the relevant situations have the same moral duties. The particular case that is presented in support of the claim that to kill is not the same (...) as to let die is based upon a rejection of consequentialism. (shrink)

Julian Le Grand's case for saying that it would be equitable if smokers and smokers alone were to pay the costs of smoking-related health care is considered and found to be deficient.

The arguments of Van Niekerk and Van Zyl that, on the grounds that it involves an inappropriate commodification and alienation of women's labour, commercial surrogate motherhood (CSM) is morally suspect are discussed and considered to be defective. In addition, doubt is cast on the notion that CSM should be illegal.

In their account of passive euthanasia, Garrard and Wilkinson present arguments that might lead one to overlook significant moral differences between killing and letting die. To kill is not the same as to let die. Similarly, there are significant differences between active and passive euthanasia. Our moral duties differ with regard to them. We are, in general, obliged to refrain from killing each and everyone. We do not have a similar obligation to try to prevent each and everyone from dying. (...) In any case, to be morally obliged to persist in trying to prevent their deaths would be different from being morally obliged to refrain from killing all other people even if we had both obligations. (shrink)

David Shaw presents a new argument to support the old claim that there is not a significant moral difference between killing and letting die and, by implication, between active and passive euthanasia. He concludes that doctors should not make a distinction between them. However, whether or not killing and letting die are morally equivalent is not as important a question as he suggests. One can justify legal distinctions on non-moral grounds. One might oppose physician- assisted suicide and active euthanasia when (...) performed by doctors on patients whether or not one is in favour of the legalisation of assisted suicide and active euthanasia. Furthermore, one can consider particular actions to be contrary to appropriate professional conduct even in the absence of legal and ethical objections to them. Someone who wants to die might want only a doctor to kill him or to help him to kill himself. However, we are not entitled to everything that we want in life or death. A doctor cannot always fittingly provide all that a patient wants or needs. It is appropriate that doctors provide their expert advice with regard to the performance of active euthanasia but they can and should do so while, qua doctors, they remain hors de combat. (shrink)

The issue of abortion is discussed with reference to the claim that people have a right of control over their own bodies. Do people "own" their own bodies? If so, what would be entailed? These questions are discussed in commonsense terms and also in relation to the jurisprudence of Hohfeld, Honore, Munzer and Waldron. It is argued that whether or not women are morally and/or should be legally entitled to have abortions, such entitlements cannot be derived from a general moral (...) entitlement to do what we will with our own bodies since there is no such entitlement. Whether or not we "own" them, we can have rights duties, liabilities, restrictions and disadvantages as well as rights concerning our own bodies. (shrink)

It has recently been suggested by Brassington that, when students in classes in medical ethics announce that some view that they wish to express is related to their religious convictions, the teacher is obliged to question them explicitly about the suggested link. Here, a different conclusion is reached. The view is upheld that, although the stratagem recommended by Brassington is permissible and might sometimes be desirable, it is not obligatory nor is it, in general, likely to be optimal.