It is with great honor and sincere apologies from the editorial staff that I introduce the long-delayed Spring 2021 issue of Ethics & Medicine. This issue marks a new chapter in the nearly four-decade history of this journal. From its beginning in the 1980s and throughout the decades since, this journal has served as an important forum for the critical examination and discussion of bioethical issues at the intersection of science, medicine, and technology, guided by the Hippocratic practice of medicine and the wealth of the Judeo-Christian worldview. The journal quickly grew in the international scope of its engagement, as E&M developed partnerships over the first two decades with the Bioethics & Public Policy Centre, The Center for Bioethics & Human Dignity, and the Lindeboom Insituut, as well as established a transatlantic editorial board.

Ethics & Medicine will enter a new era of publication with the next issue, 36:3.
Founded almost four decades ago in Edinburgh, Scotland, by Nigel M. de S. Cameron, the
journal is one of the longest running journals in the field. It has been my honor and
privilege to edit the journal for more than half of its existence. Both Nigel and I have
benefited in innumerable ways from our association with the members of the Editorial
Advisory Board and regular contributors to the journal. For those individuals, and
their enormous contributions, we are most grateful.

The new editor, I am happy to report, is the formidable Michael J. Sleasman,
PhD, Associate Professor of Bioethics and the Director of Bioethics Degree Program
at Trinity Graduate School, Trinity International University in Chicago, Illinois.

In an increasingly consumerist culture—not to mention an increasingly litigious one—physicians and patients are tempted to view their relationship as purely contractual. To do so is not only a violation of the canons of good medicine but also ultimately dangerous. Think of a legitimate contractual agreement, like that of one and one’s plumber.

I take it that it isn’t plagiarism if one identifies one’s source. In this case I have borrowed the title from an essay by the estimable Daniel Callahan from another journal, The Hastings Center Report.[1] In this essay, Callahan argues on several grounds against the legalization of physician assisted suicide and euthanasia, not least on an unbridled and undisciplined notion of patient self-determination. Likewise, philosopher Carl Elliott has explored the limits of self-determination in his ground-breaking volume, Better Than Well: American Medicine Meets the American Dream.[2] Elliott interviews patients who self-describe as “amputee wannabes” or call themselves an “amputeeby-choice.” These are individuals who see their limbs as alien to their bodies and ask physicians to remove perfectly healthy limbs because of a perfectly unhealthy body dysmorphic disorder.

As previously accepted mores crumble into the melting-pot of contemporary values, those involved in the social services find themselves beset by conflicting demands. This is particularly true in the medical field. What moral values, if any, can a doctor in practice maintain? Is he or she simply an agent of the state to meet any request a patient may have? Should a Christian doctor concede the “consensus morality” of the age rather than apply Christian principles? We believe that it is vital for us to understand what lies behind these issues, and to support each other in working out their practical application with God’s help.

Two members of the Editorial Board of ETHICS & MEDICINE had the pleasure, just before this issue went to press, of debating some of the ethical issues arising out of the Warnock Report before Durham Union Society.

ETHICS & MEDICINE commences publication with aims and a format that are modest. We wish to provide a forum for discussion on a base that is recognisably Biblical and that stems from the stream of historic Christianity.