MEDICAL ETHICS EDUCATION IN BRITAIN, 1963–1993 The transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 9 May 2006 Edited by L A Reynolds and E M Tansey Volume 31 2007 ©The Trustee of the Wellcome Trust, London, 2007 First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2007 The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183. ISBN 978 985484 113 4 All volumes are freely available online following the links to Publications/Wellcome Witnesses at www.ucl.ac.uk/histmed Technology Transfer in Britain:The case of monoclonal antibodies; Self and Non-Self: A history of autoimmunity; Endogenous Opiates; The Committee on Safety of Drugs • Making the Human Body Transparent: The impact of NMR and MRI; Research in General Practice; Drugs in Psychiatric Practice; The MRC Common Cold Unit • Early Heart Transplant Surgery in the UK • Haemophilia: Recent history of clinical management • Looking at the Unborn: Historical aspects of obstetric ultrasound • Post Penicillin Antibiotics: From acceptance to resistance? • Clinical Research in Britain, 1950–1980 • Intestinal Absorption • Origins of Neonatal Intensive Care in the UK • British Contributions to Medical Research and Education in Africa after the Second World War • Childhood Asthma and Beyond • Maternal Care • Population-based Research in South Wales:The MRC Pneumoconiosis Research Unit and the MRC Epidemiology Unit • Peptic Ulcer: Rise and fall • Leukaemia • The MRC Applied Psychology Unit • Genetic Testing • Foot and Mouth Disease: The 1967 outbreak and its aftermath • EnvironmentalToxicology: The legacy of Silent Spring • Cystic Fibrosis • Innovation in Pain Management • The Rhesus Factor and Disease Prevention • The Recent History of Platelets in Thrombosis and Other Disorders • Short-course Chemotherapy for Tuberculosis • Prenatal Corticosteroids for Reducing Morbidity and Mortality after Preterm Birth • Public Health in the 1980s and 1990s: Decline and rise? • Cholesterol, Atherosclerosis and Coronary Disease in the UK, 1950–2000 • Development of Physics Applied to Medicine in the UK, 1945–1990 • Early Development of Total Hip Replacement • The Discovery, Use and Impact of Platinum Salts as Chemotherapy Agents for Cancer • Medical Ethics Education in Britain, 1963–1993 CONTENTS Illustrations and credits v Witness Seminars: Meetings and publications; Acknowledgements E M Tansey and L A Reynolds vii Introduction Sir Kenneth Calman xxi Transcript Edited by L A Reynolds and E M Tansey 1 Appendix 1 A retrospective study and personal reflection on the influence of the Medical Groups by Ted Shotter, 16 September 2006 71 Appendix 2 Some reflections on the London Medical Group 118 Appendix 3 LMG lecture list, 1981/2 122 Appendix 4 Topics of Lectures, Symposia and Study Seminars: Associated Medical Groups, 1981/2 127 Appendix 5 Attendance at LMG lectures, symposia and annual conferences, 1972/3–81/2 131 Appendix 6 Questionnaire 132 Appendix 7 London Medical Group Presidents, 1963–89 136 Appendix 8 Donations to the LMG and the Institute of Medical Ethics, 1967–88 137 Appendix 9 Attendance at 104 lectures and symposia by topics, 1971/2 141 References 143 Biographical notes 169 Glossary 193 Index 203 ILLUSTRATIONS AND CREDITS Figure 1 Lord Amulree, Chairman of the Governing Body of the London Medical Group from 1968–81. Reproduced by permission of the Very Revd Edward Shotter. 9 Figure 2 Lord Amulree and Dr [now Professor] Alastair Campbell at the launch of the Journal of Medical Ethics in 1975. Reproduced by permission of the Very Revd Edward Shotter. 11 Figure 3 Sir Douglas Ranger, Dean of the Middlesex Hospital Medical School, at the 18th Annual Conference, ‘The Creative Urge’, held at the Royal College of Surgeons, February 1981. Reproduced by permission of the Very Revd Edward Shotter. 14 Figure 4 The Revd Professor G R Dunstan, the Revd Dr Mary Seller and Professor Norman Morris at the 18th Annual Conference on ‘The Creative Urge’, held at the Royal College of Surgeons, February 1981. Reproduced by permission of the Very Revd Edward Shotter. 17 Figure 5 Tim Helme, LMG President 1975/6 and Convenor, leading Dr Colin Murray Parkes to open the 13th Annual Conference, ‘Death: The conspiracy of silence’, held at the Middlesex Hospital Medical School, February 1976. Reproduced by permission of the Very Revd Edward Shotter. 20 Figure 6 Dr Tom Oppé (1925–2007), Dr Cicely Saunders (1918–2004) and Prebendary Edward Shotter at the 15th Annual Conference on ‘Pain: A Necessity?’, held at the Charing Cross Hospital Medical School, February 1978. Reproduced by permission of the Very Revd Edward Shotter. 20 v Figure 7 Professor John Marshall speaking to the President of the LMG, Patrick Magee (Westminster), at the pre- conference dinner and briefing of speakers for the 18th Annual Conference, ‘The Creative Urge’, held at the Royal College of Surgeons, London, February 1981. Reproduced by permission of the Very Revd Edward Shotter. 22 Figure 8 Cover of the 1993 edition of Tomorrow’s Doctors. Reproduced by permission of the General Medical Council. 39 Figure 9 One example of the evolving Seedhouse ethical grid. Reproduced by permission of Professor David Seedhouse. 54 Figure 10 The Pond Report, 1987. Reproduced by permission of Professor Kenneth Boyd. 57 Figure 11 Professor Archie Duncan and Professor Dick Welbourn, Chairman of the Editorial Board, at the launch of the Journal of Medical Ethics, 1975. Reproduced by permission of the Very Revd Edward Shotter. 66 Figure 12 Number of articles listed under the heading ‘Medical Ethics’ in Index Medicus, 1950–70. Reproduced by permission of the Very Revd Edward Shotter. 68 Table 1 LMG Conferences, 1965–89. 78 Attendance at the LMG conference, ‘Human Table 2 Sexuality’, held at the Royal College of Surgeons on 11–12 February, 1977. 83 vi WITNESS SEMINARS: MEETINGS AND PUBLICATIONS 1 In 1990 the Wellcome Trust created a History of Twentieth Century Medicine Group, associated with the Academic Unit of the Wellcome Institute for the History of Medicine, to bring together clinicians, scientists, historians and others interested in contemporary medical history. Among a number of other initiatives the format of Witness Seminars, used by the Institute of Contemporary British History to address issues of recent political history, was adopted, to promote interaction between these different groups, to emphasize the potential benefits of working jointly, and to encourage the creation and deposit of archival sources for present and future use. In June 1999 the Governors of the Wellcome Trust decided that it would be appropriate for the Academic Unit to enjoy a more formal academic affiliation and turned the Unit into the Wellcome Trust Centre for the History of Medicine at UCL from 1 October 2000. The Wellcome Trust continues to fund the Witness Seminar programme via its support for the Centre. The Witness Seminar is a particularly specialized form of oral history, where several people associated with a particular set of circumstances or events are invited to come together to discuss, debate, and agree or disagree about their memories. To date, the History of Twentieth Century Medicine Group has held nearly 50 such meetings, most of which have been published, as listed on pages xi–xviii. Subjects are usually proposed by, or through, members of the Programme Committee of the Group, which includes professional historians of medicine, practicing scientists and clinicians, and once an appropriate topic has been agreed, suitable participants are identified and invited. This inevitably leads to further contacts, and more suggestions of people to invite. As the organization of the meeting progresses, a flexible outline plan for the meeting is devised, usually with assistance from the meeting’s chairman, and some participants are invited to ‘set the ball rolling’ on particular themes, by speaking for a short period to initiate and stimulate further discussion. 1 The following text also appears in the ‘Introduction’ to recent volumes of Wellcome Witnesses to Twentieth Century Medicine published by the Wellcome Trust and the Wellcome Trust Centre for the History of Medicine at UCL. vii Each meeting is fully recorded, the tapes are transcribed and the unedited transcript is immediately sent to every participant. Each is asked to check his or her own contributions and to provide brief biographical details. The editors turn the transcript into readable text, and participants’ minor corrections and comments are incorporated into that text, while biographical and bibliographical details are added as footnotes, as are more substantial comments and additional material provided by participants. The final scripts are then sent to every contributor, accompanied by forms assigning copyright to the Wellcome Trust. Copies of all additional correspondence received during the editorial process are deposited with the records of each meeting in Archives and Manuscripts, Wellcome Library, London. As with all our meetings, we hope that even if the precise details of some of the technical sections are not clear to the non-specialist, the sense and significance of the events will be understandable. Our aim is for the volumes that emerge from these meetings to inform those with a general interest in the history of modern medicine and medical science; to provide historians with new insights, fresh material for study, and further themes