There are few in depth attempts to address the question: why teach ethics to medical students? This thesis argues that, identifying moral growth and development as the primary goal in teaching medical ethics is essential. Lawrence Kohlberg's moral development theory is the starting point for this research. This is important to understand the work of the researcher at the Medial School in Kuwait. The instrument used in assessing the moral reasoning of medical students at Kuwait University is the Defining Issues Test (DIT), which was devised at the University of Minnesota. The study hypothesis is that the rigid, authoritarian medical education in Kuwait University that lacks any emphasis on medical ethics will inhibit the expected growth in moral development of medical students. With a disappointing response rate of only 27.8%, it was found that normally expected growth did not occur in the first four years of medical education, suggesting that the educational experience somehow inhibited student's moral reasoning ability rather than facilitating it. The results of this study cannot be understood in isolation from the general understanding of the fabric of the researcher society, which was detailed in Chapter Five. The implication of this study is basically that medical education that ignores the moral nature of medicine will fail its own purpose, the needs of its students and the welfare of society.

The aim of this thesis is to deconstruct the ethical framework, in which the theological community deliberates the new reproductive technologies (NRTs) and to interrogate the constructions of woman and the embryo that have correlated into the ensuing discourses from ecclesiastic traditions. The foundational premise is that the church does not fulfil its pastoral and prophetic role in this increasingly vital socio-cultural area, predominantly because woman’s subject position of invisibility in theological discourses prevents the church from speaking differently to the secular world. The methodology establishes the validity of using critical discourse analysis as a tool of deconstruction based on the insights of Michel Foucault. This is then deployed to interrogate the constructions of woman and the embryo circulating in the popular NRT narratives of the media in order to ground a secular baseline. From this vantage point, critical discourse analysis is undertaken on two church reports and three theological texts. The concluding chapter sketches a different framework of moral perception, within which the church would be enabled to offer greater empathy in its pastoral care and also to prophetically challenge macro-systems of power more effectively.

This thesis is a qualitative study of infertility clinicians in the UK, exploring how they manage ethical issues: a study that uses empirical methods to explore ethical questions. I use a broadly Aristotelian conception of the relationship between theory and practice to develop a methodology for considering practical ethical issues. I then show how this approach, when allied with contemporary qualitative methodologies, can provide particularly valuable insights and produce practical recommendations. An important element of my approach is that a close attention to actual practice can also result in refining and developing our ethical theories and principles – practice informs theory just as theory can inform practice. This account of the ethical decision-making processes of infertility clinicians can not only highlight new ethical problems, but also develop more nuanced moral norms and ethical theories to deal with the conflicts and issues that arise in the clinical setting. Infertility treatment is a speciality that has attracted much attention from the public and bioethicists. The focus has been predominately on the dramatic aspects such as the status of the embryo or underlying issues such as the ethical boundaries of procreative liberty. Relatively little, however, is known about the everyday moral workings of infertility clinics: how clinicians approach ethical issues on a daily basis; what for them are troubling issues; and how they resolve ethical conflict. This study aims to gain insight into the way clinicians actually make ethical decisions. Moving on from this, it critically evaluates such processes and offers both an analysis of the strengths and weaknesses of the clinicians’ ethical decision-making and considers how this form of decision-making can be extended and supported in practice. The aims of this thesis are to contribute to the debate on both how ethical decision-making in the infertility clinic can be improved and, more generally, how bioethics can make a useful contribute to practical problems.

In this thesis I explore, both philosophically and empirically, the moral significance of genetic relatedness within the father/child relationship. In doing so I utilise a novel ‘empirical bioethics’ approach, in which I use specifically gathered qualitative data to inform the philosophical debate. I present qualitative data, gathered over 12 focus groups, which explores men’s normative constructions of fatherhood. The data suggests that fatherhood is essentially a social relationship, constructed within a narrative of responsibility, and that there is a distinction between being a ‘father’ and being a ‘progenitor, both of which give rise to different kinds of responsibilities and rights. I go on to construct a normative framework of paternal rights and responsibilities, which is informed by the qualitative data. I make a distinction between ‘material’ and ‘paternal’ responsibility, and in doing so I argue that a man can cause a child to exist, and be fiscally responsible for a child, without being a father. I argue that a man becomes a father (in a valuable sense), and earns paternal rights, when he accepts paternal responsibility and forms a paternal relationship with a child.

Medical confidentiality is integral to the doctor - patient relationship and an important element in efficient and effective medical practice. However, it is generally acknowledged that medical confidentiality can not be absolute. At times it must be broken in order to serve a ‘higher’ interest - be it public health or the legal justice system. Yet, very little is known about the historical evolution of the boundaries of medical confidentiality in Britain. The absence of detailed historical research on the subject has meant that contemporary writers have tended to use citations of the Hippocratic Oath or short quotations from key legal cases to place their work into longer term context. The current thesis provides a more detailed examination of the delineation of the boundaries of medical confidentiality during a period of intense debate - the interwar years of the twentieth century. The increase in state interest in the health of the population, the growth in divorce after the First World War and the prominence of the medical issues of venereal disease and abortion, all brought unprecedented challenges to the traditional concept of medical confidentiality. Having examined the, oft-cited, benchmark precedent for medical confidentiality from the late eighteenth century, the thesis proceeds to examine the ways in which medicine had changed by the interwar years. The high-point of the debate in the early 1920s is examined from the perspective of the three key interest groups - the Ministry of Health, the British Medical Association and the Lord Chancellor. Overall, the work provides insight into the historical delineation of medical confidentiality in Britain, both in statute and common law. As such it lends a longer-term context to current debates over the boundaries of medical confidentiality in the twenty-first century.