'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.

The Ties That Bind Us: Ritual, Fusion, and Identification

Most social scientists endorse some version of the claim that participating in collective rituals promotes social cohesion. The systematic testing and evaluation of this claim, however, has been prevented by a lack of precision regarding the nature of both ‘ritual’and ‘social cohesion’ as well as a lack of integration between the theories and findings of the social and evolutionary sciences. By directly addressing these challenges, we argue that a systematic investigation and evaluation of the claim that ritual promotes social cohesion is achievable.

We present a general and testable theory of the relationship between ritual, cohesion, and cooperation that more precisely connects particular elements of ‘ritual,’ such as causal opacity and emotional arousal, to two particular forms
of ‘social cohesion’: group identification and identity fusion. Further, we ground this theory in an evolutionary account of why particular modes of ritual practice would be adaptive for societies with particular resource acquisition strategies. In setting out our conceptual framework we report numerous ongoing investigations that test our hypotheses against data from controlled psychological experiments as well as from theethnographic, archaeological, and historical records.

Ritual, Play and Animals in early human societies: Manipulating the Bones in temple period Malta: Eating and Augury in the Maltese Temples.

Examination of antiquarian records and feasting ritual in prehistoric Malta

Pots, prestige and ritual in neolithic southern Italy,

Malone, C.A.T., in Papers in Italian Archaeology IV. Vol. ii. Prehistory, C.A.T. Malone and S.K.F. Stoddart, (eds.). 1985, British Archaeological Reports, Oxford: Cambridge. p. 118-151.

Daily life behind the ritual of the Temple Builders,

Stoddart, S.K.F., C.A.T. Malone, and D. Trump, in Past ( 1988, Prehistoric Society p. 4-5.