OBJECTIVES: To investigate the need for hospital clinical ethics committees by studying the frequency with which ethical dilemmas arose, the perceived adequacy of the process of their resolution, and the teaching and training of staff in medical ethics. DESIGN: Interviews with individuals and three multidisciplinary teams; questionnaire to randomly selected individuals. SETTING: Two major London children's hospitals. RESULTS: Ethical dilemmas arose frequently but were resolved in a relatively unstructured fashion. Ethical concerns included: the validity of consent for investigations and treatment; (...) lack of children's involvement in consent; initiation of heroic or futile treatments; resource allocation. Staff expressed the need for a forum which would provide consultation on ethical issues, develop guidelines for good ethical practice, undertake teaching and training, and provide ethical reflection outside the acute clinical setting. CONCLUSION: Multidisciplinary, accountable and audited clinical ethics committees with predominantly advisory, practice development and educational roles could provide a valuable contribution to UK clinical practice and perhaps in other countries that have not developed hospital clinical ethics committees. (shrink)

Russia is a country of extremes, as everyone knows. No matter what we do we are driven, as a rule, now to the extreme left and then to the extreme right. In the contemporary historiography of Soviet philosophy, such extreme turns lie at the surface. Among such extremes, I would include, in particular, the article "The Suppression of Philosophy in the USSR" [Podavlenie filosofii v SSSR], which appeared in Russian Philosophy. A Concise Encyclopedic Dictionary [Russkaia filosofiia. Malyi entsiklopedicheskii slovar'] . (...) I do not wish to say that one should not write about the suppression of Soviet philosophy. The problem is to maintain the necessary proportions. (shrink)