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Ethics in Health Care You are on night shift, running two operating theatres. A recidivist drunken driver is in one, having his arm reimplanted. In quick succession, you have five more candidates for theatre: three women for emergency caesareans, a 22-year-old stabbing victim you have reason to believe is a drug-dealer, and a nun in her seventies whose chances of survival also depend on how long she has to wait for surgery. You have a rationing dilemma: who among the newcomers goes to surgery first, or at all, tonight? Not all can. Do you have to go through with the long process, already under way, of the arm reimplantion in the first theatre? How might ethics guide you here? Is there any agreed, simple ethical formula you can tap into to get the right answer? No. Do you then have to give up on ethics? No. So, which criteria for allocating the theatres and staff should you go for? -- and in consultation with the other staff? -- and with the candidates? > How should the criteria be chosen and weighted? > What of the chances of success, and to what degree, for each person with and without surgery? > What about life expectation, and quality of life? > Should age be a criterion at all, if not why not, and if so why, and to what degree? > How much are babies worth as against adults? > Is your view of the 'social worth' of the candidates to count? If so, how much? To what extent should you follow a queuing principle, according to which, other things being equal, it is first come, first served?- but other things are not equal. And so on..... You make your decisions.... It is a long night. The outcome in due course: three healthy new babies, five healthy adults and one dead adult. Looking back on that night later on, how can you reasonably justify the choices you made? This is the sort of dilemma - though not all are so starkly immediate - that a participant might bring to the Ethics in Health Care Course at the University of Oxford's Centre for Professional Development. This course is a freestanding module at the Master's level, as well as being an accredited unit on the University's MSc in Evidence-Based Heath Care. It aims to help participants analyse and assess arguments within the ethics of health care; to argue effectively, taking the strongest counter- arguments into account; to apply some main ethical concepts and theories to selected moral dilemmas; to appraise some main current frameworks for discussion of health-care ethics; and to articulate their own moral values. The syllabus covers aspects of ethical theory and relates them to health- care and to specific topics within that, such as consent, autonomy, resource allocation, and issues at the beginning and end of life. Student- led seminars, and the course assignment itself, analyse ethical dilemmas participants have met in their own professional experience. Resources are discussed, such as the UK Clinical Ethics Network. Donald Hill, of Ethox, University of Oxford, is course tutor. Visiting lecturers are Dr. Helen Aveyard, of Oxford Brookes University, and Prof. Tony Hope, Prof. Michael Parker and Dr. Anne Slowther, all of Ethox. The taught part of the next course is over five full days in Oxford on 22 and 29 September and 6,11 and 13 October 2005. Those wishing to may complete a piece of assessed work over the following 7 weeks and earn academic credit which may be counted towards a Postgraduate Qualification. For more information or to register contact Phoebe Chen Tel: +44 (0)1865 286947 Fax: +44 (0)1865 286934 [log in to unmask] www.conted.ox.ac.uk/health