The art of medicine is often dominated by the learning of facts. We are encouraged to collate symptoms, signs, results and imaging to produce diagnoses, prognoses, cures and palliations. Mrs Reeves becomes ‘CCF in bed 7’ and Mr Reynolds, ‘acute-on-chronic renal failure in 10’. Learning ethics at medical school should be about remembering the humanity behind the diseases. Unfortunately, too many students are put off by believing that ethics is all about common sense or not relevant to them because it is often based around theories that are older than the patients they are treating. Lectures can be full of jargon and confusing terminology that seems to have no place by the bedside. We want this book to show you that this is not the case. In its guidance Tomorrow’s Doctors (2003) the General Medical Council states that medical ‘graduates must know about and understand the main ethical and legal issues they will come across’. It identifies issues of confidentiality and consent, the withholding and withdrawing of life-prolonging treatment, and the treatment of vulnerable patients such as children and those with psychiatric illnesses. With these recommendations medical schools are looking to assess more than just a student’s ability to memorize facts. They are looking to turn students into trustworthy and honest doctors with high levels of communication skills and professionalism. Studying ethics can help students with these skills as it makes them more aware of the patient as an individual rather than a disease process. It also gives them the skills to assess, evaluate and justify their views in the variety of emotionally draining and complex ethical, legal and social situations they will come across while practising as a doctor. The aim of this book is to demonstrate some of these issues through clinical scenarios, which are based on realistic cases. As well as looking at the ethical and legal issues we also want to demonstrate what should happen from a clinical point of view and provide practical guidance that a medical student or junior doctor can use rather than focusing too much on different ethical theories and legal cases and statutes. The questions we have asked about each case scenario are by no means exhaustive. Every scenario will have different ethical and legal issues stemming from it and the answers are intended to be a springboard from which to develop your own analysis and understanding of the situation. With many of the cases there is no right or wrong answer and we implore you to think what your gut feeling is and go on to explore why you feel that way. We hope the cases will give you a taste of the myriad ethical dilemmas you could encounter on a hospital ward, and we have suggested further reading in each area at the end of the book to help you build on your knowledge. Enjoy and good luck!

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