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Doyal brings together findings from a wide range of empirical studies spanning the social sciences to explore experiences of HIV positive people across the world. This will illustrate how the disease is physically manifested and psychologically internalised by individuals in diverse ways depending on the biological, social, cultural and economic circumstances in which they find themselves. A proper understanding of these commonalities and differences will be essential if future strategies are to be effective in mitigating the effects of HIV and AIDS.

It’s not too late to grant Charles Byrne’s wish, argue Len Doyal and Thomas Muinzer

Benatar argues that it is better never to have been born because of the harms always associated with human existence. Non-existence entails no harm, along with no experience of the absence of any benefits that existence might offer. Therefore, he maintains that procreation is morally irresponsible, along with the use of reproductive technology to have children. Women should seek termination if they become pregnant and it would be better for potential future generations if humans become extinct as soon as humanely possible. These views are challenged by the argument that while decisions not to procreate may be rational on the grounds of the harm that might occur, it may equally rational to gamble under certain circumstances that future children would be better-off experiencing the harms and benefits of life rather than never having the opportunity of experiencing anything. To the degree that Benatar’s arguments preclude the potential rationality of any such gamble, their moral relevance to concrete issues concerning human reproduction is weakened. However, he is right to emphasise the importance of foreseen harm when decisions are made to attempt to have children.

Some argue, for example, that ethical judgements within medicine should primarily serve the public interest by maximising the common good rather than the rights and associated claims of individual patients. [...]the patient who demands what will probably be futile cardiopulmonary resuscitation will be seen as wasting scarce medical resources which can serve the interests of others who need them more. Rules of discussion and debate are designed to ensure that relevant expertise and evidence are heard, that the process is democratic, that corrupting vested interests are removed, and that bullying based on professional seniority and power is banned-all principles of good procedural ethics.\\n While many hospitals do now have such committees, it is clear that they are not as integrated into hospital life as well as they might be. 4 In this issue (see page 451 ), Whitehead et al 5 describe some interesting research suggesting that very few clinical dilemmas are actually sent to CECs.

The fact that one or two individuals who share his genetic mutation who have no moral or legal status as \"relatives\" may now think otherwise is irrelevant. 5 The authors argue that Byrne's skeleton should be kept and displayed just in case it leads to further medical discoveries. [...]show his memory some respect.

[...]once the issues are recognised, most junior doctors are in our experience all too happy to discuss, sometimes passionately, instances of ethical and even legal violations from their own experiences. [...]discussions highlight the potential disjunction between what is taught to undergraduates and graduates about ethics and law and what happens in 'real' life, prompting reflection on how to improve this teaching to make it as useful and relevant as possible.

Unlike other clinical circumstances where the non-provision or withdrawal of treatment would have had to be discussed, debated and clinically justified in the medical record, a DNR order could simply be issued, possibly by a junior doctor with no formal or explicit justification. Since the possible need for CPR and the potential for a DNR order were not ordinarily discussed with competent adults, this meant that not only was there no opportunity for competent patients to refuse CPR; there was equally no chance for them to demand it if they were worried that it might later be denied to them. Since the early 1990s, such guidance has been published by organisations as varied as the Department of Health (2000), the British Medical Association and the Royal College of Nursing (2007), the Resuscitation Council UK (2005, 2009) and a host of separate NHS Trusts.

[...]primary care can be a much more solitary activity where there may be little time or opportunity for professional feedback and reinforcement. GPs have no such luxury and often have a stronger sense of partnership and even emotional attachment with the patients in their care. [...]in this richer emotional and narrative environment, they may well wish to resist a patient's refusal of treatment advice (for example, as regards not taking insulin, improperly using inhalers, or refusing to stop smoking).