Madam, – The restatement by the Adelaide Hospital Society of its interpretation of the charter of Tallaght Hospital (Letters, December 29th) is to be welcomed in the spirit of free speech and collegiality, as long as it is not taken to imply the assent or formal endorsement of this interpretation by the staff of the hospital.
However, it is unhelpful for Dr Fergus O’Ferrall to portray clinical ethics as being viewed by me (or anyone in the hospital!) as a situation where “medical consultants are viewed as the fount of all knowledge”. Our clinical ethics teaching programmes emphasise the importance of moral agency for all involved, including medical students, and the clear need for ethical formation and dialogue in, and among, all clinical disciplines at all levels. I am involved, for example, in ethics teaching with disciplines such as speech and language therapy and physiotherapy. Not only are we supportive of joint lay involvement in areas such as the Medical Council, but also encourage the use of the medical humanities – literature, film, music and theatre – to illuminate personal and societal perspectives on ethical and practice issues.
Perhaps the largest challenge, as outlined in our papers in the Irish Medical Journal, is to try to ensure that non-clinician ethicists work wherever possible with interested clinicians, as otherwise they risk missing out on therapeutic approaches and opportunities of advances and flexibilities of informed clinical practice. Without this joint work, non-clinician ethicists may retreat to artificial dichotomies that make for good debating material but can impoverish the choices and opportunities for patients and their families. – Yours, etc,