Who’s still coming to work?

An interesting article in the BMJ from Daniel Sokel (ethicist at UCL) discussing the moral decisions of medical staff in choosing whether to come to work in the midst of a pandemic out break.

He makes a sensible plea for a discussion now as when the outbreak occurs will be to late to discuss the matter in suitable depth! Hospitals around the globe have had to deal with this reality (Hong Kong & Toronto in SARS). Unfortuantly Sokel outlines some of the pertinent facts but fails to determine a process for deciding what an individual should do, although he has elsewhere and was presmubably on a space brief. Does personal autonomy here trump professional duty? Where are the boundaries of professional duty and are they same for all individuals in all circumstances ? A collegue to mine, Dale Gardiner, has written an eloquent exposition of his personal position on the same topic.

Stop it!

This paper from the BMJ is an eloquent explanation of the risks of stopping medical trials early.

(BTW I reckon this is exactly the sort of paper the BMJ ought to publish, the sort of thing all doctors are likely to be interested in)

Square Riggers & Safety

This interesting commentary piece from JAMA looks at the culture of safety in the US coast guard and contrasts it with that of modern health care. Maybe its of more interest if you’re a sailor! Anyway I for one will be shouting AVAST!! at the next opportunity. A strong argument that the culture in medicine needs to change to be one of “safety first”. However, it’s easier when one doesn’t have to sail, in medicine we must leave port quickly & regardless of the weather, ability of the crew, state of the boat and knowledge of the waters. In these circumstances it seems more reasonable to go for a “make do & mend” approach!

athens access or JAMA subscription required for full text