Ethics

In 1988 I took out a subscription to the Journal of Medical Ethics. It was not cheap, and not an easy read, but its four issues per year were manageable and interesting. Gradually a bloating set in. I was finding the journal unmanageable and less interesting, and cancelled my subscription.

Sometime in the 1990s, four issues became six. In 2000, it sprung an offshoot, Medical Humanities, with its own two issues yearly. The next year, its seven lines per inch were replaced with an eye-straining eight lines per inch. By 2003, its overall size grew from a friendly sub-quarto to a standard but more overbearing A4, although at least it lost its extra line per inch. In 2005, the main journal became monthly. I just couldn't keep up. I was reading less and less, and experiencing a large amount of déjà lu.

The subjects considered by the journal are endlessly fascinating: abortion, euthanasia, confidentiality. But I can't help feeling that there is nothing new, and that it is probably not a good thing (as Michael Rawlins and Anthony Culyer tried to do), to tangle with a philosopher. Articles were followed next issue by ‘A response to …’, and so ad infinitum. The full title of one article in the journal was ‘Response to a response’. Book reviews, latterly consigned to the electronic edition, dealt with books about reproductive issues, healthcare rationing, futility, third world issues but rarely did they refer to the many previous books which in their turn had been reviewed in previous issues. There was some experimental ethics, commonly surveys of responses to situations, but I never saw any evidence that the authors of purely philosophical papers did literature searches. Occasionally a new topic would burst forth, with a flurry of philosophical interest, but a sense of ennui set in with the realisation that the wider world would take no notice of the ethical issues anyway.

Nonetheless, I persevered for the increasingly rare pearls, until the dragon tyrant ended it for me. In a long paper, an analogy was drawn between death and a dragon that terrorised a town by eating thousands of people every month. Such a dragon being obviously a bad thing, imposing a moral duty to slay the dragon: thus death also was a bad thing, to be defeated. The author did explain that the intention was not lifespan extension as such, but the human ‘healthspan’ — but that is stating the obvious, and scarcely needed the dragon. Soon after that, the Journal of Medical Ethics and I parted company.

• © British Journal of General Practice, 2007.