Shot in the arm for those with health concerns

By ESTELLE SARNEY

People concerned about how the health system operates have a new independent body to call that may seek changes on their behalf.

David Seedhouse has been appointed professor of health and social ethics at the Auckland University of Technology, and is setting up a National Centre in Health and Social Ethics.

"People often end up getting shoved from pillar to post and no-one addresses their problem," says Professor Seedhouse. "It can be helpful to contact an independent place where they can at least talk to someone about the ethics of any issue they are confronted with in the health system, and there may be ways we can assist."

Professor Seedhouse cites the Gisborne cervical screening inquiry and the Liam Holloway cancer case, as examples of problems in the health system that receive a lot of publicity in the media, but not enough debate among professionals and ordinary people about what those areas of the system should be trying to achieve.

"What does 'mental health' mean? Does it mean someone is happy, able to cope, that it's okay to live as a recluse or on the street if they want to? And who ought to decide about people's health? Should it always be doctors, the courts, patients, parents, children? Unless we get down to these sorts of general issues we're going to meet the same problems again and again.

"So the centre will organise occasional conferences on topics that seem interesting and try to get under the surface of them by giving all involved the chance to have a say, including ordinary people."

Professor Seedhouse will also work directly with nursing and medical students and post-graduates on ethical issues, such as maintaining the dignity of patients. In his previous role as professor in health care analysis at the University of Middlesex in London, he visited elderly care institutions to assess and advise on this issue, and hopes to do the same here.

"Dignity is about matching people's capabilities with their circumstances. If an elderly person can and wants to make coffee in their own room, but the institution doesn't allow it, then that's not very dignified. At home they could choose whether to answer the door, but can they choose whether to receive visitors at the institution? At home they could eat what, where and when they liked, but if they're only offered a choice of two meals at set times and nothing suits them, they're stuck. They seem like small things but they're actually very important. It's about taking people seriously."

Professor Seedhouse originally studied philosophy in England before branching into the field of medical ethics 15 years ago. He has worked for medical schools in Britain and at the Auckland Medical School, where he was senior lecturer in medical ethics from 1992 to 1998, and in various health departments in Britain.

His textbooks are used throughout the world by medical, nursing and other health science students.

His centre at AUT is offering a post-graduate certificate in health and social ethics, which from the middle of next year will also be available to study via the internet.