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The Journal of the Institute of Medical Ethics The Journal of Medical Ethics was established in 1975, with a multidisciplinary editorial board, to promote the study of contemporary medico-moral problems. The editorial board has as its aims the encouragement of a high academic standard for this developing subject and the influencing of the quality of both professional and public discussion. The journal is published quarterly and includes papers on all aspects of medical ethics, analyses ethical concepts and theories and features case conferences and comment on clinical practice. It alsG contains book reviews. Editorial Board EDITOR: Raanan Gillon, BA (PHILOSOPHY), MB, BS, MRCP. Director, Imperial College Health Service, University of London, and Visiting Professor, Centre of Medical Law and Ethics, King's College, University of London. CONSULTING EDITORS: Sir Douglas Black, Emeritus Professor of Medicine, Manchester University. D W Hamlyn, Emeritus Professor of Philosophy, Birkbeck College, London University. EDITORIAL BOARD: Thomas Oppe, Chairman: Professor of Paediatrics, St Mary's Hospital Medical School, London. K M Boyd, Scottish Director, Institute of Medical Ethics, Edinburgh. Alastair Campbell, Senior Lecturer, Department of Christian Ethics and Practical Theology, Edinburgh University. A W Clare, Professor of Psychological Medicine, St Bartholomew's Hospital Medical College, London. John Dawson, Head of Professional Division, British Medical Association, London. Robin Downie, Professor of Moral Philosophy, Glasgow University. A S Duncan, Emeritus Professor of Medical Education, Edinburgh University. C M Fletcher, Emeritus Professor of Clinical Epidemiology, London University. R M Hare, Professor of Moral Philosophy, University of Florida, Gainesville, USA. Roger Higgs, Case conference editor, General Practitioner and Director of General Practice Studies, King's College School of Medicine and Dentistry, London. Margot Jefferys, Emeritus Professor of Medical Sociology, University of London. Ian Kennedy, Professor of Medical Law and Ethics, King's College, London. Professor Sir Malcolm Macnaughton, Department of Obstetrics and Gynaecology, Glasgow University Professor John Mahoney S7, F D Maurice Professor of Moral and Social Theology at King's College University. David Paterson, Executive Producer, Science and Features, BBC Television, London. Sir Martin Roth, Professor of Psychiatry, Cambridge. Robert Sells, Director, Renal Transplant Unit, Liverpool Royal Infirmary, Liverpool. Elliot A Shinebourne, Consultant Paediatric Cardiologist, Brompton Hospital, London. Paul Sieghart, Barrister, Gray's Inn, London. Gerald Stern, Consultant Neurologist, University College Hospital, London. Keith Ward, Professor of History and Philosophy of Religion, King's College, London. R B Welbourn, Emeritus Professor of Surgical Endocrinology, Royal Postgraduate Medical School, London. Eric Wilkes, Emeritus Professor of Community Care and General Practice, Sheffield University. Professor jenifer Wilson-Barnett, Department of Nursing Studies, King's College London (KQC), University of London. Edward Shotter, Director, Institute of Medical Ethics, ex officio. Submitting manuscripts for publication Papers submitted for publication should be sent in quadruplicate to: The Editor, Journal of Medical Ethics, 151 Great Portland Street, London WlN SPB. Rejected manuscripts are not returned unless accompanied by a stamped addressed envelope, or international reply coupon. Papers should be in double-spaced typewriting on one side of the paper only. A total word count is appreciated. On a separate sheet some brief biographical details should be supplied, including the title of the author's present post, degrees and/or professional qualifications, (if any) and any other relevant information. Four copies of the journal will be sent to authors free of charge after their papers are published. Offprints of individual papers may be bought from Professional and Scientific Publications, Tavistock House East, Tavistock Square, London WC1H 9JR. In March 1981 the JME adopted a simplified 'Vancouver style' for references: details are given in various issues, including December 1986. They are also available from the editorial office. The full text of the 'Vancouver Agreement' was published in the British MedicalJournal in 1982; volume 284; 1766-70. As the 'Vancouver style' is incompatible with the long established style of references for legal articles, lawyers should use their own standard style, but try to facilitate reference by others. The journal is multidisciplinary and papers should be in clear jargon-free English, accessible to any intelligent reader. Notice to subscribers The Journal of Medical Ethics is published quarterly. The annual subscription rates are £35.00 in the United Kingdom and Irish Republic, and £53.00 in all countries overseas. US direct $77.00. Payment for overseas subscriptions should be made in sterling, payable to Professional and Scientific Publications/JME A/c. Orders can also be placed locally with any leading subscription agent or bookseller. (For the convenience of readers in the USA subscription orders, with or without payment, can also be sent to: Professional and Scientific Publications, British Medical Journal, Box No 560B, Kennebunkport, Maine 04046. All enquiries, however, must be addressed to the publisher in London). All enquiries regarding air mail rates, single copies, advertisements, etc, should be sent to: Professional and Scientific Publications, Tavistock House East, Tavistock Square, London WC1H 9JR. ISSN 0306-6800 Copyright © 1988 Journal of Medical Ethics. All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the Journal of Medical Ethics. EDITORIAL ASSOCIATES: Dr Anthony Hope, Oxford Dr Simon Lundy, London TECHNICAL EDITOR: EDITORIAL SECRETARY: Ann Lloyd, London. Maureen Bannatyne, London. Thematic review and index The thematic review of past issues appears in the June issue each year and an index to each volume appears in the December issue.

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Page 1: TheJournalofthe Institute Medical Ethics · the paper only. A total word count is appreciated. On a separate sheet some brief biographical details should be supplied, including the

The Journal of the Institute of Medical EthicsThe Journal of Medical Ethics was established in 1975, with a multidisciplinary editorial board, to promote the study ofcontemporary medico-moral problems. The editorial board has as its aims the encouragement of a high academic standard forthis developing subject and the influencing of the quality of both professional and public discussion. The journal is publishedquarterly and includes papers on all aspects of medical ethics, analyses ethical concepts and theories and features caseconferences and comment on clinical practice. It alsG contains book reviews.

Editorial BoardEDITOR:Raanan Gillon, BA (PHILOSOPHY), MB, BS, MRCP. Director,Imperial College Health Service, University of London, andVisiting Professor, Centre of Medical Law and Ethics, King'sCollege, University of London.CONSULTING EDITORS:Sir Douglas Black, Emeritus Professor of Medicine,Manchester University.D W Hamlyn, Emeritus Professor of Philosophy, BirkbeckCollege, London University.EDITORIAL BOARD:Thomas Oppe, Chairman: Professor of Paediatrics, St Mary'sHospital Medical School, London.K M Boyd, Scottish Director, Institute of Medical Ethics,Edinburgh.Alastair Campbell, Senior Lecturer, Department of ChristianEthics and Practical Theology, Edinburgh University.A W Clare, Professor of Psychological Medicine, StBartholomew's Hospital Medical College, London.John Dawson, Head of Professional Division, British MedicalAssociation, London.Robin Downie, Professor of Moral Philosophy, GlasgowUniversity.A S Duncan, Emeritus Professor of Medical Education,Edinburgh University.C M Fletcher, Emeritus Professor of Clinical Epidemiology,London University.R M Hare, Professor of Moral Philosophy, University ofFlorida, Gainesville, USA.Roger Higgs, Case conference editor, General Practitioner andDirector ofGeneral Practice Studies, King's College School ofMedicine and Dentistry, London.Margot Jefferys, Emeritus Professor of Medical Sociology,University of London.Ian Kennedy, Professor of Medical Law and Ethics, King'sCollege, London.Professor Sir Malcolm Macnaughton, Department ofObstetrics and Gynaecology, Glasgow UniversityProfessor John Mahoney S7, F D Maurice Professor of Moraland Social Theology at King's College University.David Paterson, Executive Producer, Science and Features,BBC Television, London.Sir Martin Roth, Professor of Psychiatry, Cambridge.Robert Sells, Director, Renal Transplant Unit, LiverpoolRoyal Infirmary, Liverpool.Elliot A Shinebourne, Consultant Paediatric Cardiologist,Brompton Hospital, London.Paul Sieghart, Barrister, Gray's Inn, London.Gerald Stern, Consultant Neurologist, University CollegeHospital, London.Keith Ward, Professor of History and Philosophy of Religion,King's College, London.R B Welbourn, Emeritus Professor of SurgicalEndocrinology, Royal Postgraduate Medical School,London.Eric Wilkes, Emeritus Professor of Community Care andGeneral Practice, Sheffield University.Professor jenifer Wilson-Barnett, Department of NursingStudies, King's College London (KQC), University ofLondon.Edward Shotter, Director, Institute of Medical Ethics,ex officio.

Submitting manuscripts for publicationPapers submitted for publication should be sent inquadruplicate to: The Editor, Journal ofMedical Ethics, 151Great Portland Street, London WlN SPB. Rejectedmanuscripts are not returned unless accompanied by astamped addressed envelope, or international reply coupon.Papers should be in double-spaced typewriting on one side ofthe paper only. A total word count is appreciated. On aseparate sheet some brief biographical details should besupplied, including the title of the author's present post,degrees and/or professional qualifications, (if any) and anyother relevant information.Four copies of the journal will be sent to authors free of

charge after their papers are published. Offprints ofindividual papers may be bought from Professional andScientific Publications, Tavistock House East, TavistockSquare, London WC1H 9JR.

In March 1981 theJME adopted a simplified 'Vancouverstyle' for references: details are given in various issues,including December 1986. They are also available from theeditorial office. The full text of the 'Vancouver Agreement'was published in the British MedicalJournal in 1982; volume284; 1766-70. As the 'Vancouver style' is incompatible withthe long established style of references for legal articles,lawyers should use their own standard style, but try tofacilitate reference by others. The journal is multidisciplinaryand papers should be in clear jargon-free English, accessibleto any intelligent reader.

Notice to subscribersThe Journal of Medical Ethics is published quarterly. Theannual subscription rates are £35.00 in the United Kingdomand Irish Republic, and £53.00 in all countries overseas. USdirect $77.00. Payment for overseas subscriptions should bemade in sterling, payable to Professional and ScientificPublications/JME A/c. Orders can also be placed locally withany leading subscription agent or bookseller. (For theconvenience of readers in the USA subscription orders, withor without payment, can also be sent to: Professional andScientific Publications, British Medical Journal, Box No560B, Kennebunkport, Maine 04046. All enquiries,however, must be addressed to the publisher in London). Allenquiries regarding air mail rates, single copies,advertisements, etc, should be sent to: Professional andScientific Publications, Tavistock House East, TavistockSquare, London WC1H 9JR.ISSN 0306-6800

Copyright © 1988 Journal of Medical Ethics. All RightsReserved. No part of this publication may be reproduced,stored in a retrieval system, or transmitted, in any form or byany means, electronic, mechanical, photocopying, recordingor otherwise, without the prior permission of the Journal ofMedical Ethics.EDITORIAL ASSOCIATES:Dr Anthony Hope, Oxford Dr Simon Lundy, LondonTECHNICAL EDITOR: EDITORIAL SECRETARY:Ann Lloyd, London. Maureen Bannatyne, London.

Thematic review and indexThe thematic review of past issues appears in theJune issue each year and an index to each volumeappears in the December issue.

Page 2: TheJournalofthe Institute Medical Ethics · the paper only. A total word count is appreciated. On a separate sheet some brief biographical details should be supplied, including the

Alexander Broadie 203

glory in his riches: but let him that glories glory in this,that he understands and knows Me' [Jer 9, 22-3].These words of Jeremiah lie at the heart of

Maimonides's moral philosophy and there is nomistaking the urgency of tone when he quotes them.There are, of course, many today for whom thosewords will have at most a merely aesthetic appeal. Buteven for those unsympathetic to Jeremiah's words,there is much in Maimonides's ethical theory relating

to his account of virtue and vice and the means bywhich the one can be promoted and the other banished,which is of interest. His teaching in that area is asrelevant to us today as it was to the twelfth centuryNorth African cultural scene which Maimonides did somuch to enrich.

Alexander Broadie is Reader in Philosophy at theUniversity ofGlasgow.

News and notesTennent Caledonian and Royal Bank of Scotland ResearchFellowships 1989-90Applications are invited for these research Further details are available from the Director,fellowships for the academic session 1989-90. The Dr John Haldane, Centre for Philosophy and Publicfellowships are intended primarily, though not Affairs.exclusively, for philosophers and political theorists Applications, including a cv, a short statement ofon study leave from their own universities. research intentions or plans, and an indication of theAppointment is normally for one term and the term during which the fellowship would be held,fellowship carries a travel allowance, accommodation should be submitted to: The Establishments Officer,in St Andrews, a room in the Department of Moral University of St Andrews, St Andrews, Fife,Philosophy and access to word-processing facilities. KY16 9AL

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Journal of medical ethics, 1988, 14, 217-222

Medical EthicsThe Journal of theInstitute ofMedical Ethics

Volume FourteenNumbers 1-4

EDITORIAL ASSOCIATES:Dr Anthony Hope, Oxford Dr Simon Lundy, London

TECHNICAL EDITOR: EDITORIAL SECRETARY:Ann Lloyd, London. Maureen Bannatyne, London.

Editorial BoardEDITOR:Raanan Gillon, BA (PHILOSOPHY), MB, BS, MRCP. Director,Imperial College Health Service, University of London, andVisiting Professor, Centre ofMedical Law and Ethics, King'sCollege, University of London.CONSULTING EDITORS:Sir Douglas Black, Emeritus Professor of Medicine,Manchester University.D W Hamlyn, Emeritus Professor of Philosophy, BirkbeckCollege, London University.EDITORIAL BOARD:Thomas Oppe, Chairman: Professor of Paediatrics, St Mary'sHospital Medical School, London.K M Boyd, Scottish Director, Institute of Medical Ethics,Edinburgh.Alastair Campbell, Senior Lecturer, Department of ChristianEthics and Practical Theology, Edinburgh University.A W Clare, Professor of Psychological Medicine, StBartholomew's Hospital Medical College, London.J7ohn Dawson, Head of Professional Division, British MedicalAssociation, London.Robin Downie, Professor of Moral Philosophy, GlasgowUniversity.A S Duncan, Emeritus Professor of Medical Education,Edinburgh University.C M Fletcher, Emeritus Professor of Clinical Epidemiology,London University.R M Hare, Professor of Moral Philosophy, University ofFlorida, Gainesville, USA.Roger Higgs, Case conference editor, General Practitioner andDirector ofGeneral Practice Studies, King's College School ofMedicine and Dentistry, London.Margot jefferys, Emeritus Professor of Medical Sociology,University of London.Ian Kennedy, Professor of Medical Law and Ethics, King'sCollege, London.Professor Sir Malcolm Macnaughton, Department ofObstetrics and Gynaecology, Glasgow UniversityProfessorJohn Mahoney SJ, F D Maurice Professor of Moraland Social Theology at King's College University.David Paterson, Executive Producer, Science and Features,BBC Television, London.Sir Martin Roth, Professor of Psychiatry, Cambridge.Robert Sells, Director, Renal Transplant Unit, LiverpoolRoyal Infirmary, Liverpool.Elliot A Shinebourne, Consultant Paediatric Cardiologist,Brompton Hospital, London.Paul Sieghart, Barrister, Gray's Inn, London.Gerald Stern, Consultant Neurologist, University CollegeHospital, London.Keith Ward, Professor of History and Philosophy of Religion,King's College, London.R B Welbourn, Emeritus Professor of SurgicalEndocrinology, Royal Postgraduate Medical School,London.Eric Wilkes, Emeritus Professor of Community Care andGeneral Practice, Sheffield University.Professor J'enifer Wilson-Barnett, Department of NursingStudies, King's College London (KQC), University ofLondon.Edward Shotter, Director, Institute of Medical Ethics,ex off cio.

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J7ournal ofmedical ethics, 1988, 14, 220-222

Index to Volume 14

AAlderson, Priscilla, 14, 50, 51Almond, Brenda, 14, 173-178Anderson, Garland, 14, 18-24Animals, handicapped children and thetragedy of marginal cases, 14, 191-193Arnold, Robert M, 14, 91-96Attempting to demystify law reportsfor the non-lawyer, 14, 35-37At the coalface (list in alphabeticalorder)

Boxing clever, 14, 69Suffer the little children someautonomy, 14, 204-205

Autonomy of demented patients, The:interviews with caregivers 14, 184-187

BBarnes, Dame Josephine, 14, 162-163Bevan, Gwyn, 14, 53Biological processes and moral events,14, 144-148Book reviews (list in alphabeticalorder)

AIDS, ethics and public policyedited by Christine Pierce andDonald Van de Veer, 14, 111Bioethics and belief by JohnMahoney SJ, 14, 49By no extraordinary means byJoanne Lynn, 14, 51-52Care of the handicapped newborn,parental responsibility and medicalresponsibility, The CatholicBishops' Joint Committee onBio-ethical Issues, 14, 48-49Case studies in nursing ethics byRobertM Veatch and Sarah T Fry,14, 109COMET, a computer programdealing with consent to medicaltreatment by Paul Sieghart andJohn Dawson, 14, 212-213Critical issues in the earlydevelopment of premature infantsby Sibylle K Escalona, 14, 213Ethical issues in death and dyingedited by Robert F Weir, 14, 48Ethics and regulation of clinicalresearc'h by Robert J Levine, 14,

44 46Euthanasia and the newborn editedby R McMillan, H R Engelhardtand S Spicker, 14, 53Foetus as transplant donor, The:scientific, social and ethicalperspectives by Peter McCullagh,14, 50-51Growing old in the future edited byC F Hollander andH A Becker, 14,213-214Guidelines on the termination of lifesustaining treatment, a report bythe Hastings Center, 14, 212Healing and suffering - theChristian paradox by Paul Feider,14, 215Health: the foundations forachievement by David Seedhouse,14,49Human experimentation. A guidedstep into the unknown by WilliamA Silverman, 14, 46In search of the modemHippocrates edited by Roger JBulger, 14, 49-50Law relating to the health careprofessions, The byC F Bayliss, 14,215-216Legal aspects ofmedical practice byBernard Knight, 14, 214-215Life before birth: consensus inmedical ethics by Kenneth Boyd,Brendan Callaghan S J and EdwardShotter, 14, 44Medicine in contemporary society:King's College Studies 1986-7edited by Peter Byrne, 14, 109-110Mental health services - law andpractice by Larry Gostin, 14, 46-47Pastoral care and ethical issues inand out of work: a pastoralperspective by Paul H Ballard, 14,214Patient as partner, The by RobertM Veatch, 14, 52Persons and personality by ArthurPeacocke and Grant Gillett, 14,161-162Psychology, ethics and changeedited by Susan and Gavin

Fairbairn, 14, 214Recollections and reflections byDouglas Black, 14, 162-163Reproductive genetics and the lawby S Elias and G J Annas, 14, 108Rights, restitution and risk: essaysin moral theory, by Judith JarvisThomson, 14, 110Saggi du medicina e scienze umaneby G Mascitelli, A Ponsetto, NLuhmann, MG Lombardo, H JHelle and R Contardi, 14, 108-109Setting limits by Daniel Callahan,14, 163Shared concern (video) by theSociety of Parents Helping inEducation, 14, 50The price of health by George JAgich and Charles E Begley, 14, 53The sanctity of life doctrine inmedicine: a critique by HelgaKuhse, 14, 161Tough decisions by JohnMFreeman and Kevin McDonnell,14, 107-108Transsexualism and sexreassignment by William A WWalters and Michael W Ross, 14,47-48

Bredlau, Peter, 14, 42-43Broadie, Alexander, 14, 200-203Brueton, M J, 14, 48-49Buckle, Stephen, 14, 144-148Byrne, Peter, 14, 161

CClayton, R M, 14, 108Competition in medical ethics: Casehistory, 14, 38Competition in medical ethics:Persons and values, 14, 39-41Competition in medical ethics: Wouldit have been better had he died? 14,42-43Confidentiality: a modified value, 14,87-90Correspondence (list in alphabeticalorder)

Infanticide for the handicappednewborn, 14, 223

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Index to Volume 14, 1988 221

Response to Confidentiality: a

modified value, 14, 165The physician as critic, 14, 165-166

Craig, D G, 14, 214-215

DDavies, Jean, 14, 148-149Davis, Alison, 14, 150-153, 223Debate: (list in alphabetical order)

Resolving arguments about thesanctity of life: response to Long,14, 198-199

Draper, Heather, 14, 47-48Dugdale, Tony, 14, 46-47Duncan, A, 14, 212-213

EEditorial: (list in alphabetical order)

Euthanasia, withholding life-prolonging treatment, and moraldifferences between killing andletting die, 14, 115-117Genetic counselling,confidentiality, and the medicalinterests of relatives, 14, 171-173Living wills, powers ofattorney andmedical practice, 14, 59-61Pregnancy, obstetrics and the moralstatus of the fetus, 14, 3-4

Edwards, A, 14, 111Ekman, S-L, 14, 184-187Emery, Alan, 14, 49Emson, H E, 14, 87-90Ethical aspects of genetic disease andgenetic counselling, 14, 194-197Ethical dilemmas in pharmacy, 14,31-34Euthanasia, letting die and the pause,14, 61-68Fairbairn, Gavin J, 14, 132-134Ferguson-Smith, Marie E, 14, 44Fletcher, Vivien, A A, 14, 35-37Forrow, Lachlan, 14, 91-96At the coafface: (list in alphabeticalorder)

For whom the bells knell, 14,140-141Commentary: For whom the bellsknell, 14, 142-143Suffer the little children someautonomy, 14, 204-205

GGillett, Grant, 14, 61-68Girard, Marc, 14, 25-30

HHaldane, John J, 14, 39-41Hamblin, T J, 14, 109-110Handicapped infants: medical ethicsand the law, 14, 5-10Hammond, J, 14, 53Health and disease: What can medicinedo for philosophy, 14, 118-124Heim, Michael, 14, 140-141

Heintz, Lawrence L, 14, 82-86Holm, S0ren, 14, 77-78Hope, R A, 14, 161-162Howie, J G R, 14, 52

IInfanticide for handicapped infants:sometimes it's a metaphysical dispute,14, 79-81Irwin, W G, 14, 125-128Is AIDS a just punishment?, 14,154-160

JJennett, Bryan, 14, 51-52, 142-143Jolley, Milly, 14, 188-193

KKastrup, Marianne, 14, 179-183Keatinge, Richard, 14, 213-214Khin Zaw, Susan, 14, 49-50Kluge, Eike-Henner W, 14, 206-210Kottow, Michael, 14, 165Kuhse, Helga, 14, 198-199Kuhse, Singer and slippery slopes, 14,132-134

LLavin, Michael, 14, 129-131Legislative hazard: keeping patientsliving, against their wills, 14, 82-86Litigation and complaints procedures:objectives, effectiveness andalternatives, 14, 70-76Lesser, Harry, 14, 110Long, Thomas A, 14, 79-81Lowenthal, Werner, 14, 31-34Laurence, D R, 14, 44 46

MMackay, R D, 14, 135-139McClelland, R J, 14, 125-128McWhorter, John Henry, 14, 165-166Medical groups, 14, 56, 112, 168, 224Moral theories: (list in alphabeticalorder)

Moral philosophy of Maimonides,The, 14, 200-203

Murphy, Timothy F, 14, 154-160

NNelson, James Lindemann, 14, 191-193News and notes, 14, 105-106, 164,203New Danish law: human life begins atconception, 14, 77-78Norberg, A, 14, 184-187Notice to contributors, 14, 167, 222

pPhilosophy, medicine and itstechnologies, 14, 173-178Poem: Case Report, 14, 97Point of view: (list in alphabeticalorder)

Ethics of cancer management fromthe patient's perspective, 14,

188-193

Premature breech, The: caesareansection or trial of labour?, 14, 18-24Preston, Ronald, 14, 49Prodomo, Raffaele, 14, 108-109Psychiatry and the death penalty, 14,179-183Pugsley, Robin, 14, 212

RRaphael, D D, 14, 5-10

SScadding, J G, 14, 118-124Shennan, Victoria, 14, 215-216Shoben, Loretta, 14, 214Singer, Peter, 14, 198-199Solgaard, Torfinn, 14, 97Speck, Peter, 14, 48Status of anencephalic babies, The:should these babies be used as donorbanks?, 14, 150-153Stchedroff, M, 14, 125-128Steinbach, Tully, 14, 140-141Stout, R W, 14, 125-128Strong, Carson, 14, 18-24Sutton, Agneta, 14, 214Szawarski, Zbigniew, 14, 11-17

TTeaching medical ethics: (list inalphabetical order)

Teaching clinical medical ethics: amodel-programme for primary careresidency, 14, 91-96Multidisciplinary teaching in aformal medical ethics course forclinical students, 14, 125-128

Technical expertise as an ethical form:towards an ethics ofdistance, 14,25-30Teno, Joan, 14, 91-96Terminating life-sustaining treatment-recent US developments, 14, 135-139Toon, Peter D, 14, 69, 107-108Treatment of defective newborns, The- a survey of paediatricians in Warsaw,14, 11-17Tulczynski, Aleksander, 14, 11-17

WWachenje, Vivienne, 14, 204-205Watts, John, 14, 46Wartman, Steven A, 14, 91-96West, Richard, 14, 194-197, 213What doctors should call their patients,14, 129-131Whawell, Michael, 14, 215Whelan, Christopher J, 14, 70-76When caesarian section operationsimposed by a court are justified, 14,206-210Williamson, J, 14, 163Wilson-Barnett, Jenifer, 14, 109Words: Raping and making love aredifferent concepts: so are killing andvoluntary euthanasia, 14, 148-149

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Joumal ofmedical ethics, 1988, 14, 222

Notice for contributors to the Journal ofMedical Ethics

Submitting manuscriptsfor publicationFour copies of papers submitted forpublication should be sent to: The Editor,J3ournal ofMedical Ethics, IME Publications,151 Great Portland Street, London WIN5PB. Rejected manuscripts are not returnedunless accompanied by an adequatelystamped addressed envelope, or internationalreply coupon. Papers, including references,should be in double-spaced typewriting onone side of the paper only. An approximateword-coun. is helpful. On a separate sheetbrief details of the author's present post, anaddress for readers' correspondence and anyother relevant information should besupplied.

TheJME uses a simplified 'Vancouver style'for references. The full text ofthe sVancouverAgreement was published in the Britishmedicaljournal in 1982; Volume 284; 1766/1770. As the 'Vancouver style' isincompatible with the long established styleofreferences for legal articles, lawyers shoulduse their own standard style, but avoidabbreviations so as to facilitate reference byothers. The journal is multidisciplinary andpapers should be in clear jargon-freeEnglish, accessible to any inteiligentreader.

Authors are asked to avoid footnoteswherever possible. Articles for the journalshould be between 600 and 3500 words inlength except book reviews which should bebetween 300 and 1200 words. Abbreviationsshould be avoided. The names of journals,organisations etc should be given in full.

Four copies of the journal will be sent toauthors free ofcharge after their papers arepublished. Offprints of individual papersmay be bought from Professional andScientific Publications UME), TavistockHouse East, Tavistock Square, LondonWC1H 9JR.

Simplified 'Vancouver style'All papers submitted for publication shouldcontain the following:1 On page one of the manuscript there shouldbe:a) the title of the article which should be

concise but informative and designed toattract the reader. The Editor reservesthe right to change titles to achieve these

ends.b) names, initials and academic degrees (if

any) of author or authorsright to change titles to achieve theseends.

b) names, initials and academic degrees (ifany) of author or authors

c) names of department(s) andinstitution(s) to which the work shouldbe attributed, if any

d) disclaimers, if anye) source(s) of support, if any

2 On page two there should be:a) an interesting abstract or summary of notmore than 150 words. Emphasise importantand/or new aspects of the article to attractthe potential readerb) key (indexing) terms - below theabstract. Provide and identify as such,three to six key words or short phases thatwill assist indexers in cross-indexing yourarticle and that may be published with theabstract.Where appropriate, use terms from theMedical Subject Headings List fromINDEX Medicus

3 Acknowledgements:Acknowledge only persons who have madesubstantive contributions to the study.Authors are responsible for obtainingwritten permission from everyoneacknowledged by name because readersmay infer the latter's endorsement of dataand conclusions.

4 References:Number these consecutively in the order inwhich they are first mentioned in the text,tables, and captions, by arabic numerals (inparenthesis). The list of references at theend ofthe paper should be numbered in theorder in which each reference appears inthe text. Try to avoid using abstracts asreferences. 'Unpublished observations'and 'personal communications' may not beused as references, although references towritten, not verbal, communications maybe inserted (in parenthesis) in the text.Manuscripts accepted but not yet publishedmay be used as references - designate thejournal followed by 'in press' (inparenthesis). Information frommanuscripts submitted but not acceptedshould be cited in the text as 'unpublishedobservations' (in parenthesis).

References must be verified by theauthor(s) against the original documents.

The following scheme, a simplification ofthe'Vancouver style' for biomedicaljournals, should be followed for eachreference: in the text - number (inparenthesis); in the list - author (list allauthors if six or less; if seven or more, listonly the first three and add 'et al)', title,name of publication if different from title;place of publication and publisher (whereappropriate); year of publication; and,where appropriate, volume, number andpage references of article or chapterreferred to. Examples of correct forms ofreference are given below:a) Standard journal article:

(1) Paul E F, Paul J. Self-ownership,abortion and infanticide. J7ournal ofmedical ethics 1979; 5: 133-138.

b) Corporate author:(2) Conference of Royal Colleges and

Faculties of the United Kingdom.Diagnosis of brain death. Lancet1976; 2: 1060-1070.

c) No author given:(3) Anonymous. On telling dying

patients the truth [editorial]. Journalofmedical ethics 1982; 8: 117-119.

d) Personal author(s):(4)Hick J. Death and eternal life.

Glasgow and London: Collins, 1976.e) Editor, compiler, chairman as author:

(5) Phillips C E, Wolfe J N, eds.Clinical practice and economics.Tunbridge Wells: Pitman Medical,1977.

f) Chapter in book:(6) Armstrong C N. Intersexuality in

man. In: Armstrong C N, MarshallA J, eds. Intersexuality in vertebratesincluding man. London: AcademicPress, 1964: 349-352.

g) Agency publication:(7) The Linacre Centre for the Study of

Ethics and Health Care. Paper 1:The principle of respect for humanlife. In: Prolongation of life.London: The Linacre Centre for theStudy of Ethics and Health Care,1978.

h) Newspaper article:(8) Dinwoodie R. Volunteers die as

heart drug results baffle doctors.The Scotsman 1980 Sept 5: 11 (cols1-6).

i) Magazine article:(9) James J. Homoeopathy - the

treatment of like with like. TheListener 1980 Aug 21: 234-236.

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Journal ofmedical ethics, 1988, 14, 224

Medical groups

ABERDEEN MEDICAL GROUPDrM D McArthur, Glenburn Wing,Wood End Hospital, Aberdeen

BIRMINGHAM MEDICAL GROUPMrR Sawers, Birmingham MaternityHospital, Queen Elizabeth MedicalCentre, Edgbaston, BirminghamB15 2TG

BRISTOL MEDICAL GROUPMark Herbert esq, Hiatt Baker Hall,Parry's Lane, Stoke Bishop, BristolBS9 1AD

CARDIFF MEDICAL GROUPDr R D Hutton, Institute ofPathology, Royal Infirmary, CardiffCF2 lSZ

DUNDEE MEDICAL GROUPDr David B Walsh, Consultant inBiochemical Medicine, NinewellsHospital, Dundee

EDINBURGH MEDICAL GROUPMrs Maureen S Macmillan,Nursing Studies Research Unit,12 Buccleuch Place,Edinburgh EH8

GLASGOW MEDICAL GROUPMr Harry Burns,Department of Surgery,Glasgow Royal Infirmary,Glasgow G4 OSF

LEEDS MEDICAL GROUPMr Brian Bentley, Principal of theSchool of Radiography,General Infirmary, Belmont Grove,Leeds LS2 9NS

LEICESTER MEDICAL GROUPDr J S Rodgers,District Medical Officer,Kettering Health Authority,District Offices, Rothwell Road,Kettering, Northants NN16 8VZ

LIVERPOOL MEDICAL GROUPDavid Seedhouse, Lecturer in HealthPromotion, Department of GeneralPractice, Liverpool University, POBox 147, Liverpool L69 3BX

LONDON MEDICAL GROUPMrs Diana Cookson, Room 68,Tavistock House North, TavistockSquare, London WC1H 9LG

MANCHESTER MEDICAL GROUPDr Andrew Procter, RusholmeHealth Centre, Walmer Street,Manchester M14 5NP

NEWCASTLE MEDICAL GROUPThe Revd Bryan Vernon, Anglicanchaplain, Newcastle University,Claremont Buildings,Newcastle upon Tyne NEI 7RU

OXFORD MEDICAL FORUMDr Andrew Wood,MRC Clinical Pharmacology Unit,Oxford

SOUTHAMPTON MEDICAL GROUPThe Revd T Pinner, 8 Bassett Close,Southampton S02 3FP

Medical groups associated with theInstitute of Medical Ethics have beenestablished in British universityteaching hospitals. Each academic yearthey arrange programmes of lecturesand symposia on issues raised by thepractice of medicine which concernother disciplines. Although theseprogrammes are addressed primarily tomedical, nursing and other hospitalstudents they are open to all membersof the medical, nursing and alliedprofessions. There is no fee forattendance. Lecture lists are availableby direct application to the appropriateco-ordinating secretary named above.A stamped addressed A4 envelopewould be appreciated.

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Institute of Medical EthisPRESIDENT

SiriDouglas Black, MD FRCP

VICE PRESIDENTS

Professor A S Duncan, DSc MB ChB FRCSEFRCOG FRCPE MD (Hon)

Professor G R Dunstan, (Hon) DD (Hon) LLDFSA

Professor R B Welbourn, MA MD (Hon)DScFRCS (Hon)FACS

GOVERNING BODY

R D Catterall, CBE FRCPE

Allan Chappell, CIPFA, (Treasurer)Colin Currie, RD FRCP

Roger Higgs, MBE MA MB MRCP FRCGP

Professor Bryan Jennett, MD FRCS

Professor Ian Kennedy, LLM

David Layton, MBE MA

The Earl of Limerick, KBE MA CA

Stephen Lock, MA MB FRCP

Professor John Mahoney SJ, MA DD

Professor Thomas Oppe, CBE FRCP DCH(Chairman)A R Peacocke, MA DSc

Sir John Prideaux

Robert Sells, MA FRCS

Paul SieghartRichard West, MD FRCP DCH DObst RCOG

Jenifer Wilson-Barnett, SRN DipN BA MSc PhDRNT FRCN

DirectorEdward Shotter, BA

Scottish DirectorKenneth Boyd, MA BD PhD

Editor, Journal of Medical EthicsRaanan Gillon, BA (Phil) MB BS MRCP

Editor, IME BulletinRichard Nicholson, MA BM DCH

The Institute of Medical Ethics is a centre for research, educationinformation. It is financed by grants from charitable bgovernment sources and members' subscriptions.

It was established as the Society for the Study of Medical Ethiand is an independent, non-partisan organisation for the m

disciplinary study of medico-moral issues raised by the practicemedicine.

The institute aims to influence the quality of both professional an

public discussion of medico-moral questions; to promote the studymedical ethics; to ensure a high academic standard for this developsubject; to encourage a multidisciplinary approach to discussionthe consequences of clinical practice; to stimulate research in specifi

problems, and to remain non-partisan and independent of all interestgroups and lobbies.

The institute undertakes research on medico-moral questions,sponsors a major educational programme and provides an informationservice for members.

Two reports, The Ethics of Resource Allocation in Health Care byKenneth Boyd and Dilemmas of Dying by Ian Thompson, werel

published, by the Edinburgh University Press, a few years ago.

In 1986 two more reports were published. One, on the ethics o

clinical research investigations on children, Medical Research i

Children: Ethics, Law and Practice by Richard Nicholson was

published by the Oxford University Press and Life Before Birth - theSearch for a Consensus on Abortion and the Treatment of Infertility byKenneth Boyd, Brendan Callaghan and Edward Shotter, was

published by SPCK. The Pond Report on Teaching Medical Ethics, a

summary of which appeared in the IME Bulletin, was published ml

full last year. IThe institute derives from the London Medical Group, a student

group for the study of issues raised by the practice of medicine which,since 1963, has arranged a comprehensive programme of lectures andsymposia on medico-moral issues raised by the practice of medicine.Similar groups associated with the institute have been established inuniversity teaching hospitals at Aberdeen, Birmingham, Bristol,Cambridge, Cardiff, Dundee, Edinburgh, Glasgow, Leeds,Leicester, Liverpool, Manchester, Newcastle, Oxford, Sheffield andSouthampton.

Membership of the institute is open to all those who work in themedical and allied professions or who have an interest in medicalethics. Members receive a monthly briefing on current developments,the Bulletin of the IME. The quarterly Journal of Medical Ethics is

available by separate subscription.

Institute ofMedical EthicsTavistock House North,Tavistock Square, London WC1H 9LG

Tel: 01-387 8132

IME Publications151 Great Portland StreetLondon WIN 5FB

Tel: 01-580 5282

Published by the Institute of Medical Ethics: London.Typesetting and artwork by Abalex Phototypesetting Co Ltd, Slough, Berks. Printed by Whitefriars Press, Tonbridge, Kent.