Desperately Seeking Science: The Creation of Knowledge in Family Practice

Most medical consultations are for self-limiting conditions. While technical expertise remains necessary, creating therapeutic knowledge in this context is the joint responsibility of physician and patient, and depends upon recognition that the observer, the observation, and the observed form a temporary union.     

Applying the case method for teaching within the health professions--teaching the teachers

The case method provides training in problem solving and is useful in clinical education within health professions. The method consumes less teaching resources and might be useful in a situation with increasing numbers of students and staff cuts. As it is a relatively new method within the Faculty of Medicine, University of Lund, a training program for teachers has been established with a short, practical, course. This paper describes the application and introduction of the case method and evaluation of the introductory course by 106 teachers. In this course the case method is introduced and demonstrated. The participants construct cases and take an active part as both students and teachers. Almost everyone was planning to incorporate the case method in their teaching practice, at both undergraduate and graduate levels. To have constructed and led cases themselves was considered a great strength. More time was requested as well as a follow-up session after practically using the case method.     

Testing the embryo, testing the fetus

This paper stems from an ethnographic, multidisciplinary study that explored the views and experiences of practitioners and scientists on social, ethical and clinical dilemmas encountered when working in the area of PGD for serious genetic disorders. We focus here on staff perceptions and experiences of working with embryos and helping women/couples to make choices that will result in selecting embryos for transfer and disposal of 'affected' embryos, compared to the termination of affected pregnancies following PND. Analysis and discussion of our data led us to consider the possible advantages of PGD and whether a gradualist account of the embryo's and fetus's moral status can account for all of these, particularly since a gradualist account concentrates on the significance of time (developmental stage) and makes no comment as to the significance of place (in-vitro, in-utero).     

Bioethics in the Language of the Law

Law provides a rich language for thinking about bioethical issues and is a tool for action as well as talk. But the language of the law, often inapt, regularly fails to achieve its desired effect.     

Beyond the Moral Status of the Fetus

Book reviewed in this article: Abortion and Woman's Choice: The State, Sexuality, and Reproductive Freedom . By Rosalind P. Petchesky. Abortion and the Politics of Motherhood . By Kristin Luker.     

Medicine and the public: the 1962 report of the Royal College of Physicians and the new public health

The 1962 report of the Royal College of Physicians on smoking was a significant event in the history of smoking. Its significance was, however, more than smoking-specific: the RCP committee's appointment, its membership, its work, and the manner of its publication signified the changes within social medicine, and within the medical profession more generally, in postwar Britain. Doctors assumed the right to speak to the public and to government on matters of individual health, and a new risk-based public health was in the process of formation. A public health "policy community" formed, and governments began to assume responsibility for advising the public on health matters. The use of research in the report, and of social research in response to it, was important in the emergence of evidence-based medicine within public health. The paper argues for greater attention to the change in public health epitomized by the report in current debates on the concept of the 1960s "permissive society." It was the harbinger of a new style of "coercive permissiveness" in health.