FROM OTHER JOURNALS

As this journal enters the 25th year of its publication, Dr. Bette- Jane Crigger, Editor reminisces on its evolution from a twelve- page newsletter into the leading journal in this field. “We will, of course, continue to explore a range o f philosophical paradigms, principalism, casuism, feminism and narrative ethics... (and) how best to understand and manage the thickness of lived moral experience... We need to attend more carefully to what ‘moral discourse’ sounds like spoken in ordinary voices. The trick, always, is not simply to reflect the current state of play in bioethics, but to press new questions and probe new analytic paradigms as well...”

Among essays published in this issue are those on caring for patients in cross- cultural settings, refusal of treatment by Christian Scientists and abortion. A special supplement (pages S1 - S32) deals with long- acting contraception. The issue also contains a symposium (pages 36- 46) on research involving embryos.

The case study in this issue discusses,
The forgetful mourner, an eighty- six year old woman with Alzheimer’s disease who kept forgetting that her son had died. Each time she was reminded of this she experienced the pain of her loss as if for the first time. Sustained deception was considered and ‘ruled out by her attendants. An aide solved the problem by dressing her in the black dress she had worn whilst attending the funeral. Tony Yang- Lewis and Harry Moody discuss questions such as whether a patient with Alzheimer’s disease should be told the truth, whether the patient’s receptivity to truth was relevant and whether it was correct to attempt to shield such a patient from a painful truth.

Otago Bioethics Report 1994; 3: 1- 15
Two essays (pages 4- 7) review assisted human reproduction.

Alison Douglass offers for debate thoughts on surveys aimed at studying patient satisfaction (pages 8- 9). She stresses the need to recognise the limitation of such surveys and the avoidance of bias from non- response and poor selection of sample. It is necessary to assess both the quality of care afforded to patients as well as what could be termed ‘hotel services’, the distinction between these being clearly understood by responding patients. She highlights as key points the need for statistical integrity, voluntary and informed participation by responding patients, protection of the privacy and confidentiality of these vulnerable patients who are undergoing stressful experiences and ensuring justice and equality so that participants have access to the results of the survey.

Katherine Hall and Jan Crosthwaite offer commentaries on the case notes on Karen L whose parents wanted all treatment on their seriously ill daughter stopped as they believed that she would not survive. (Karen’s treatment was continued by the doctors, She recovered and returned to employment.)