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Americans owning guns are a large group but remain a minority. We are arguably the only group that remains socially acceptable to hate or defame. Even groups and individuals professing [...]

Objective: Little has been written in the medical literature concerning the ethics of treatment of the elderly demented patient with bowel obstruction. It is one example of the issues with which we are becoming increasingly involved. We conducted a survey of our colleagues' opinions to determine current practice. Design: A postal questionnaire study (62% response rate). Questions were posed that related to a case scenario of an elderly demented patient presenting with a presumed sigmoid volvulus. Setting: The northern region of England. Participants: Thirty seven surgical members of the Association of Coloproctology of Great Britain and Ireland, Northern Chapter. Results: Sixty five per cent of respondents felt that surgery would be inappropriate, and 26% that any intervention at all upon the subject in the case scenario would be inappropriate. More would operate, however, at the request of relatives. An advance directive not to treat would be respected by 70% despite a relative's wishes. Conclusions: Overall there was a wide variation in the approach of the surgeons to a demented patient with bowel obstruction. In an era of clinical governance, and an increased awareness of the ethics of consent, this study presents one example of the difficult decisions with which we are increasingly faced. The greater use of advance directives may provide one possible solution., The gulf between what can be done and what should be done expands with innovation. The correct answer to what should be done is perhaps dynamic, changing over time with [...]

A policy of 'preventive detention' has recently been debated in the British Parliament. Alarmed by the high-profile criminal activities of people suspected of having dangerous severe personality disorder (DSPD), the government have made clear their intention to 'indeterminately but reviewably detain' people with DSPD, after diagnosis by forensic psychiatrists, even if the individuals are yet to commit an offence. Such a policy may improve the safety of the public, but has obvious implications for civil liberties. This essay criticises the morality of the government's intention and rejects the notion that the medical profession could ethically collude with such a policy., On the 15th February, 1999, the then Secretary of State for the Home Office, Mr Jack Straw, announced to the House of Commons that, in conjunction with the Department of [...]

It's painful to turn in a family member to law enforcement--but most painful when your loved one faces a possible death sentence. In 1995, after my wife, Linda, and I [...]

The legal and ethical issues that surround the behavioral health field are immense in this day and age, even as professionals continue to strive to provide the best care to [...]