Taking “no” for an answer Medical education in the 21st century Australian parents have the right to decline vaccination of their children. This issue of the Journal examines Occasionally, as in the case reported how we should define a “good” medical by Goldwater et al (page 175), this graduate today. Dean and colleagues results in disease for the child, and (page 163) compare how prepared considerable ethical tension for the graduates were from different medical treating doctors. On page 150, school programs for that ultimate test, McIntyre et al consider what this case internship. Aretz’s editorial (page 147) has to teach us about the issue of affirms the value of such follow-up vaccination refusal and the best studies, while advocating new ways to approach to the tiny minority of assess other qualities required of the parents who are true conscientious 21st-century doctor. Death talk objectors. We’re at the cutting edge of educational innovation, say Nair and Euthanasia campaigner Philip Hardie in their Conference Report of Nitschke was in the news again Focus on the foreskin the 2002 Meeting of the Australian recently when Sydney Airport Speaking of medical decisions and New Zealand Association for officials confiscated a “death parents make for children, the rate Medical Education (page 152), but machine” he was taking to a US educators need to continually rethink. conference. He also took part in a of neonatal male circumcision has debate at last year’s AMA National declined markedly in Australia, in Conference on whether euthanasia line with advice from various learned Students have their say bodies. On page 155, however, and physician-assisted suicide Many of us will remember witnessing should be legalised. Opposing Spilsbury et al report a Western Australian study which suggests unethical or insensitive behaviour by speaker Margaret Somerville those senior clinicians we trailed in (page 171), Professor of Law at that phimosis is being overdiagnosed, leading to unnecessary circumcision our student days. How many of us McGill University’s Centre for actually did something about such Medicine, Ethics and Law, presents of young boys. In response, Dewan (page 148) gives some no-nonsense incidents? Bloch (page 167) her side of the debate. documents similar experiences of advice on what phimosis actually is. students today and their sense of Meanwhile, Darby (page 178) dispels powerlessness to act in these He said, she said some of the myths about why various situations. Can anything be done? cultures practised circumcision in the The accusations fly and passions Turn to this challenging Clinical first place. run high in our correspondence Ethics article to find out. columns (page 187) on subjects Kastowsky’s Personal as diverse as pertussis, ethics Perspective (page 170) describes committees, emergency the emotional odyssey of a week departments, depression guidelines, spent at the morgue as a medical the boundaries of medicine and student. pharmacoeconomic modelling. And if you thought systematic Goitre reconnoitre reviews were boring, the fallout from a recent controversial Cochrane Recent studies suggest we can no review on mammography continues, longer assume that iodine deficiency via concerns about lying and the is rare in Australia. McDonnell and quirks of the English language. colleagues (page 159) confirm this in their report on the iodine status and The mystery of the clinical trial prevalence of goitre in over 600 Melbourne schoolchildren. Our Trials on trial series continues as Gebski and Keech (page 182) Another time ... another place ... examine some of the statistical methods used in clinical trials. 1.Another time ... another place... Some psychiatrists and sociologists say Meanwhile, Mackerras (page 180) it [circumcision] is the mother exacting analyses a real trial comparing retribution for male domination in society. lifestyle modification with metformin I prefer to think mother wants it done in reducing the rate of conversion because everyone else has it done. from impaired glucose tolerance What slaves we are to conformity. to type 2 diabetes. Brian Heber (MJA 1966; 2: 729 [letter]) 146 MJA Vol 178 17 February 2003.