'Murder or Mercy?' an innovative module helping UK medical students to articulate their own ethical standpoints regarding end-of-life decisions

Objectives This student selected component (SSC) was designed to equip United Kingdom (UK) medical students to respond ethically and with sensitivity to requests they might receive as qualified doctors in regard to euthanasia and assisted dying. The aim was to expose students to relevant opinions and experiences and to provide opportunities to explore and justify their own views and rehearse ethical decision making in a safe learning environment. Method The module is delivered by specialists from a number of disciplines including law, theology, medicine and nursing, each providing students with a working knowledge allowing them to actively discuss cases, articulate their own views and practise ethical reasoning through group and individual study. Visits to local intensive care units, palliative care wards and hospices are integrated effectively with theory. Student assessment comprises a dissertation, student-led debate and reflective commentary. Module impact was evaluated by analysis of student coursework and a questionnaire. Results Students found the content stimulating and relevant to their future career and agreed that the module was well-structured and that learning outcomes were achieved. They greatly appreciated the clinical context provided by the visits and opportunities to apply ethical reasoning to real cases and to debate ethical issues with peers. Students reported an increased discernment of the ethical and legal position and practical considerations and a greater awareness of the range of professional and lay viewpoints held. Student perceptions were confirmed on analysis of their submitted coursework. Many participants were less strongly in favour of euthanasia and assisted dying on module completion than at the outset but all felt better equipped to justify their own viewpoint and to respond appropriately to patient requests. Conclusions The multi-disciplinary nature of this course is helpful in preparing students to deal effectively and sensitively with ethical dilemmas they will encounter in their medical career. Use of an integrated, learner-centred approach equips students to actively engage with their peers in discussion of such issues and to formulate and defend their own position.

Fabrication and Ms Conduct: Scrutinising Practice Through Feminist Theory

This paper describes a collaborative practice, between an architect (the author) and a textile designer; its outcomes and the critical theoretical and feminist contexts from which the practice evolved and to which it still responds. The practice advocates the interweaving of more than the yarns, material and cultures on which it is physically based, but also the intertwining of theory and technology as a means to advance architectural practice. This is done in response to Ahrentzen’s charge to feminist scholars and practitioners to ‘embrace not only the abstract conceptual nature of much postmodernist theorizing but also that derived from the serious “hanging out”, looking at, listening to, scrutinising and theorizing lived experiences of the everyday’, in this instance the everyday practice of combining concrete and textiles.

Reintegrative and Disintegrative Shaming:Legal and Ethical Issues

Abstract
This chapter considers a range of legal and ethical issues raised by the use of reintegrative and disintegrative shaming techniques (Braithwaite, 1989) with sex offenders. ‘Disintegrative shaming’ labels and stigmatises offenders, ostracises them from the local community and may result in violence directed towards offenders (McAlinden, 2005, 2007). ‘Reintegrative shaming’, on the other hand, focuses on rehabilitating the offender within a supportive community environment and assisting the offender in their efforts to change. The former is evident in the range of recent legislative responses designed to protect the community from sex offenders such as notification as well as the popular demand for measures which ‘name and shame’ known sex offenders. The latter is more clearly related to restorative measures such as circles of support and accountability. This chapter argues that although traditionally at opposite ends of the intervention spectrum, each type of mechanism gives rise to potentially difficult legal and ethical considerations.