There’s being a growing movement towards more patients accessing medical cannabis around the world but in the UK it’s still something of a taboo subject. But with a growing body of evidence in support of using marijuana for a range of conditions, should it be more readily available for patients.

Cannabis based drug Sativex was the first of its kind to be approved in the UK in 2010 and is currently used to treat some of the symptoms of multiple sclerosis, such as neuropathic pain and spasticity. However, it can only be prescribed by specialist doctors in certain circumstances and isn’t widely used. Other than Sativex, cannabis is considered to be a class B drug and cannot, therefore, be supplied for medical conditions.

As well as MS, cannabis research has suggested the drug can alleviate the symptoms of other conditions, including epilepsy, Alzheimer’s, and Parkinson’s disease but the debate on whether it should be made more widely available continues.

Yes, medical marijuana should be more readily available

One of the key factors behind the pro-medical marijuana debate is that there’s a growing body of evidence that shows it can have a positive impact on a variety of conditions. Over 40 countries, including Australia, Canada, Switzerland, and the US, have decriminalised cannabis in some form, making it far more accessible to patients that could benefit from it. The Royal College of Nursing is one of the most recent organisations to lend its voice in support, noting it can provide relieve pain and control symptoms. The organisation also points out that many painkillers are legal despite being from the same family as heroin.

Another essential point in favour of decriminalising the use of cannabis for medical purposes is the fact that many patients are already turning to the drug, potentially putting themselves in vulnerable situations as they need do so by accessing a street dealer. Legalising the drug would be patients can be certain of what they are taking and be monitored by a professional.

No, medical marijuana shouldn’t be more readily available

Of course, there is a strong case against making medical marijuana more readily available to patients. Firstly, while research has been positive, clinical data still highlights concerns, including those that show use could be dangerous and have a long-term impact that has yet to be fully explored. Some studies, for example, have suggested that long-term use of cannabis could affect critical organ function, indicating that more research would be beneficial to fully understand the effects of cannabis.

Another issue against the drug is what parameters will be set around it and how they will be enforced. For medical marijuana to be used more frequently there would need to be significant changes in regulations and how its use is governed. T

What’s your view on the subject – should doctors have greater capabilities to prescribe medical marijuana for a range of conditions?

Medical advancements mean there’s now a much greater understanding of how conditions are spread from person to person – and while treatment is also progressing, there are still many conditions that can’t be cured. This leaves professionals with a dilemma – when they know that a partner of a patient is at risk of a condition, should they inform them?

Of course, patient-doctor confidentiality in the UK legally and ethically sets out a medical professional’s responsibility to protect a patient’s personal information from improper disclosure. However, under certain circumstances, doctors may be obliged to disclose information about a patient even when their consent hasn’t been given. When it comes to communicable diseases, such as HIV, and a patient refuses to allow the information to be passed outside the healthcare team their wishes much be respected unless you consider that failure to disclose the information will put healthcare workers or other patients at risk of infection.

This ambiguity in the rules can make it challenging for professionals to weigh up what to do in these situations, with their own judgement potentially being called into question. So, should doctors ever inform partners of potential health risks?

Yes:  Partners should be informed

The argument for informing partners centres on a wider duty of care. Failing to tell a person, for example, that their partner has tested HIV+ puts them at significant risk, which is a contradiction to the role of a medical professional. Those in support of disclosing this type of information to partners will note that failing to do so means that the infection is more likely to spread. Of course, talking to the patient in questions, and encouraging them to discuss their condition with their partner, is the first course of action.

No: Partners should not be informed

Those that are against doctors disclosing medical conditions to partners tend to focus on the need for trust to be built between professional and patient, of which confidentiality is vitally important. Disclosing information when this has been refused by the patient can cause a serious breakdown in communication, trust, and future treatment for the condition. It can, as a result, cause further harm to the patient that is facing the disease.

What’s your view on revealing certain conditions to partners of the patient? Share your views with us.

As with many new areas of medicine, stem cell research is being hotly debated. It’s numerous potential benefit to further medical science are being tempered with ethical concerns. As stem cell research becomes even more prominent in a variety of medical fields, the debate is set to increase.

Stem cells are those cells that are able to differentiate into specialised cell types and can divide to produce more of the same type of stem cells. As a result, they offer the possibility or a renewable source of replacement cells and tissues. There are two broad types of stem cells. This first is adult stem cells, which can be found in various tissues and can act as a repair system for the body. There is little to no ethical debate around the use of adult stem cells. However, the second type of stem cells – embryonic stem cells – is more controversial.

In a developing embryo, stem cells can differentiate into all specialised cells making them valuable to stem cell research, but the ethics continue to be a contentious issue. Which side of the debate do you find yourself on?

In favour of stem cell research

Stem cell research holds a huge amount of potential for finding both treatments and cures for an array of diseases, from cancer and diabetes to multiple sclerosis and Alzheimer’s. With the endless opportunity to grow and study human growth and cell development, scientists stand to learn a great deal. In contrast to this gains that can be made through stem cell research, those in favour argue that it either outweighs the ethics of using embryos or that the point of life doesn’t start until after this.

Against stem cell research

The key argument against embryonic stem cell research focuses on the ethics of research involving the development, use, and destruction of human embryos. It links to the argument of when you consider life beings and whether it’s ethical to destroy an embryo that has the potential to create life. Some of the opposition against stem cell research comes from religious organisations but this is balanced with those simply concerned by the ethics of it.

It’s become a political issue too, with the debate considering how the new research should be regulated and funded. A potential solution has emerged, with researchers working to develop techniques to isolate stem cells that are as valuable as embryonic stem cells but don’t require a human embryo.

The UK is currently one of the few European countries that does allow the creation of embryonic stem cell lines, do you agree with the policy stance?


A healthcare system that is free at the point of delivery has been a part of the UK for decades and it’s often a part of the culture that’s showcased. But recently, there’s been a growing debate around whether the NHS is the best way to meet the demand for healthcare while ensuring standards are kept high and we make the most of medical advancements.

There are several reasons why universal healthcare has entered the public debate. Firstly, there have been numerous headlines commenting on the ‘crisis’ the NHS faces and mismanagement of resources. In addition, the debate from the US, has filtered to the UK. Former US President Barack Obama made steps towards a universal healthcare system, a move that divided opinions, but much of these have been cut back by current President Donald Trump. Trump has even used the UK’s ‘broken’ system as an argument against universal healthcare in the states.

But what are the pros and cons of a healthcare system that’s free at the point of deliver?

Benefits of universal healthcare

  • Equal access to healthcare – The core benefit to social healthcare is that it’s accessible to everyone. Citizens don’t have to worry about their health if they lose their job, are on a lower income, or a faced with long-term medical issues. It provides equal access to everyone, no matter their background.
  • Improvements to public health – As everyone is entitled to healthcare without having to pay, overall public health is improved across the board. It means that life expectancy increases, and overall quality of life can improve too. In turn, it can reduce pressure on other economical areas.
  • Majority of healthcare under a single system – As most healthcare is under a single system, it reduces paperwork and red tape that’s associated with health insurance and privatisation.
  • Medical costs reduced – As a universal healthcare provider, it’s possible for an organisation to buy medicine, equipment, and more in bulk, substantially reducing costs.

Drawbacks of universal healthcare

  • Potential for medical abuse – A common complaint against the NHS is that it’s open to abuse. From people attending A&E for minor ailments to patients committing fraud, it places extra financial burdens on the system and means those in real need are affected.
  • Longer wait times – As everyone is using the same system, there are longer waiting times within the NHS when compared to private healthcare. This also links to the system being open for abuse, meaning that vital resources are tied up when they’re needed. It can lead to some patients seeking private care despite the universal healthcare that’s on offer.
  • Increased taxes – While the NHS is free at the point of delivery, it’s paid through national insurance. Having access to a universal healthcare system means more leaving your paycheque every month to find it.

What’s your stance on the NHS and the universal healthcare system in general? Is universal healthcare the best option in the modern world?

From October 2016, new doctors in England were given a rewritten employment contract from their predecessors. Affecting a vast range of areas, from how much doctors can expect to get paid to whether they can switch specialties later in their career, it’s a controversial shake-up that sparked protests across the country.

But what effect does the contract really have and why were the changes brought in?

Firstly, although referred to as the ‘junior doctor contract’ frequently, the changes actually apply to all doctors below the consultant levels, so experienced, senior doctors are affected too. The changes were strongly opposed by many working in the medical profession, but they were eventually agreed on following negotiations between the government, NHS Employers, and the British Medical Associations – although the BMA voted against the new junior doctor contracts but did suspend strike action.

The changes were made following the recommendations of an independent body that aimed to improve patient outcomes across the week. It’s a reason that many of those affected rejected.

So, what are the key changes that were made?

  • Weekend work – Moving forward, weekend work is considered a normal part of the average doctor’s working week as part of the government’s pledge to create a ‘seven-day NHS’. However, most professionals that work at least seven weekends throughout a year will experience an uplift in their pay as a result.
  • Basic pay – The 55,000 junior doctors that are part of the UK did receive a basic pay rise of around 10%, however, this was below the 13.5% previously pledge by the health secretary Jeremy Hunt. According to Hunt, the lower increase is a consequence of changes to other areas of pay.
  • Night work – The amount doctors receive when working night shifts – when working more than eight hours between 8pm and 10am – has fallen. Previously factors enjoyed an extra 50% for a shift, this has fallen to 37%.
  • Safeguarding junior doctors – Much of the dispute over contracts focussed on the pressures that junior doctors face to work excessive hours, putting patient health at risk. To combat this concern, each NHS trust must now have a junior doctor forum that will advise guardians, whose role it is to ensure safe, effective working conditions.
  • Improved equality – Doctors that work part-time or take time our of the profession will now benefit from a greater level of support. Those returning to work will have access to a mentor and targeted accelerated learning programmes to help them get back up to speed.

As a doctor there are multiple career pathways open to you through specialities, ranging from general practice to anaesthesia. Choosing your medical speciality is an important but dauting decision, with a wide range of factors influencing your choice. From assessing the skills your already possess to the areas that capture your interest, there are numerous different areas to consider. If you’re unsure, the first step is to take a look at the specialities that are open to you.

The British Medical Association lists 15 specialities that are embedded within the NHS:

Academic medicine – For doctors that have a stoning interest in research, academic medicine can be incredibly rewarding. As well as undertaking research, you’ll also typically be responsible for providing patient care, teaching students, and working to create a collaborative, inquiry culture.

Anaesthesia – Anaesthetists should be able to provide services relating to pain management and resuscitation problems, as well as administering anaesthetic. It gives a choice to specialise in a particular area too, such as intensive care or obstetric anaesthesia.

Emergency medicine – Doctors specialising in emergency medicine can expect a fast-paced work environment and huge variety in the people they see. From treating people with minor illnesses through to major trauma, you’ll be responsible for handling new cases as they arrive at hospital.

General medicine specialities – There are more than 30 specialities that fall under general medicine, giving you plenty of choice. It covers from prevention right through to managing disease. Among the specialities are neurology, cardiology, and topical medicine.

General practice – GPs are the first place that many patients turn to when they have a health concern. As a result, if you were to specialise in general practice, you’re likely to work with and see a wide range of people face-to-face, it’s an excellent option for doctors that enjoy patient interaction.

Obstetrics and gynaecology – Within this speciality concerned with the healthcare of women, there are several other disciplines to choose from. Typically, trainees choose to train as generalists before undertaking further training in a particular area.

Occupational medicine – Occupational medicine practitioners work within organisations to improve the overall health and wellbeing of a workforce and reduce potential risks.

Ophthalmology – Focussed on the preservation of sight, ophthalmology blends medicine and surgery. Usually, you’ll be responsible for diagnosis, treatment, and on-going assessment of the patients that are registered to you.

Paediatrics and child health – As general physicians that work with children from birth to adulthood, paediatricians need to be able to communicate well with both young children and their parents. Much of you time would be spend on preventive medicine and assessing development, growth and future potential for children.

Pathology – Pathology encompasses several specialities the link basic science with clinical medicine to study disease and their manifestation. There are three core specialities within pathology – chemical pathology, histopathology, and medical microbiology and virology – as well as other smaller disciplines.

Psychiatry – This speciality focuses on mental illnesses, behavioural disorders, and emotional disorders in both adults and children. There’s plenty of scope when it comes to work location within psychiatry, from hospitals to patient homes to meet demand where it’s needed.

Public health medicine – Public health medicine is concerned with the prevention of infectious and non-infectious diseases within the population to improve overall. Generally public health teams are made up of professionals from across multi-disciplines.

Radiology – oncology – Divided into two specialities both radiology and oncology are essential medical areas. While radiology focuses on the study of images to make or confirm a diagnosis, oncology is the non-surgical management of malignant disease. Within both areas you’ll need to work with patients and have a broad understanding of medicine.

Sports and exercise medicine – If you want to combine medicine with sports and exercise, this could be the speciality for you. It can include a wide range of areas from the prevention of sports injuries to the nutrition needs to maintain peak performance.

Surgical specialities – Surgery specialities require a balance between intellect and physical interaction. Through this choice you can play a key role throughout the journey of a patient, from diagnosis through to treatment. There are nine specialities that fall under surgery, giving trainees plenty of scope.

One of the most common debate in the medical sector in the UK revolves around abortion. It’s an emotive topic and both sides of the argument are passionate about their stance. So, as a professional which side of the fence do you fall and does it impact on the care you deliver?

Abortion has been legal on a wide range of ground in England, Wales, and Scotland since the Abortion Act 1967 and it one of the most liberal abortion laws in Europe. Most abortions in these countries are carried out before 24 weeks of pregnancy, although they can be carried out after this point in certain circumstances, for example if the mother’s life is at risk or the child would be born with a severe disability. However, in Northern Ireland the situation is different and performing an abortion in the country is an offence except in specific cases. The abortion debate isn’t new or restricted to the UK – it’s one that’s occurring across the world.

The argument for legal abortion

One of the core arguments to legal abortion is the woman’s right to choose what happens to her body and to have control over her choices. Many argue that it’s a fundamental right that a pregnant woman is free to choose whether to proceed with the pregnancy or choose an abortion.

From a medical point of view, is the perception that personhood only starts when a foetus is viable outside of the womb, rather than at conception. Babies born before the 24-week cut off time for an abortion can occasionally survive with specialist care but the odds of survival are much lower – for this reason some people that advocate for legal abortion would like to see the timeframe reduced. Supporting when a foetus become a person is research from the Royal College of Obstetricians, which found that foetuses are incapable of feeling pain at the time that most abortions are performed.

Another argument in favour is build on the understanding that some women will still seek to have an abortion even if it’s illegal. Access to legal, professional abortions that are carried out by professionals reduces the risk of maternal death and injury.

The argument against legal abortion

The key argument against abortion is that life begins at conception – making abortion murder. It’s a view that many people take and part of what makes the debate so strong. The argument of when a foetus is considered a person is important to both sides of the debate and fundamental to where you stand.

Among the other core reasons related to why people are against abortion include religious and faith reasons, and the potential for the experience to cause psychological damage to the mother. With medical advancements, it’s also possible for mothers to choose to abort based on medical reasons. Those against abortion note that it could lead to over discrimination, where babies that would be born with genetic abnormalities could be aborted.

It’s a debate that everyone, whether they work in the medical profession or not, has an opinion on. So, which side of the argument do you back and why?

Experts have argued that it is unnecessary to finish the entire course of antibiotics despite official guidance from the NHS stating it is essential the entirety of the course is finished in order for the treatment to be successful.

An opinion piece from the British Medical Journal (BMJ) argues that there is simply not enough evidence to support the idea that failing to complete a course of antibiotics contributes to the issue of antibiotic resistance.

The piece also goes on to state that it may in fact be advisable for people to stop taking the antibiotics when they feel better, instead of completing the course, as it is believed unnecessary exposure to antibiotics could make resistance even worse. This is because patients are essentially exposing more bacteria to the antibiotics the longer they take them.

The lead author of the opinion piece, Professor Martin Llewelyn, stated: “Historically, antibiotic courses were set by precedent, driven by fear of under-treatment, with less concern about overuse […] Completing the course goes against one of the most fundamental and widespread medication beliefs people have, which is that we should take as little medication as necessary.”

However, the piece does go on to highlight that there are some exceptions. It states that for some diseases, completing the entire course of antibiotics is of paramount importance, as without doing so it could lead to life-threatening conditions.

There is still not enough research to warrant disrupting the current prescribing practices in place, and so the BMJ opinion piece suggests that it would be more pertinent for doctors to advise to ‘stop when you feel better’ as opposed to being advised to complete the entire course.

Kieran Hand, spokesman for the Royal Pharmaceutical Society, said: “This opinion article from respected NHS infection experts is a welcome opening of the debate in the UK on the relationship between the length of a course of antibiotics, efficacy and resistance.

“As researchers have pointed out, further research is needed before the ‘Finish the course’ mantra for antibiotics is changed and any alternative message, such as, ‘Stop when you feel better,’ can be confidently advocated.

“The ideal future scenario would be that the right length of treatment for a specific infection for patients is identified from clinical trials and the exact quantity prescribed and dispensed.”

Official NHS guidelines and Public Health England still state that patients should continue to complete the full antibiotic course as prescribed. Which opinion do you agree with – Should patients continue taking antibiotic even after they feel better?

Organ transplants can be crucial when it comes to saving a person’s life. An organ donation can often mean the start of a new beginning for patients suffering from the likes of heart disease, kidney failure and even some forms of cancer.

However, there is some debate over the fairness of organ donation and whether or not people who suffer from conditions that are considered to be due to lifestyle choices, such as smoking or alcohol abuse, should be given organ transplants.

NHS resources are already under a lot of pressure, and with so many patients currently waiting for organ transplants, should organ transplants always be given to the next person on the list, even if their illness could be considered self-inflicted? We look at the arguments for and against.

Arguments against treating the next person on the list

As the NHS healthcare system is currently very strained, it could lead to the argument that only those who are considered to be ‘deserving’ should ultimately be granted a transplant. There is also the issue of whether, if an alcoholic, for example, were granted a transplant, they would be able to upkeep the on-going lifestyle changes required so as not to damage the new organ they have been given.

Arguments for treating the next person on the list

On the other side of the argument, those in favour of treating the next person on the list would state that receiving an organ transplant for a potentially life-threatening condition is a basic human right. As well as this, the NHS is an equal healthcare system and so medical professionals within it have a duty of care to all their patients.

There is also the issue of deciding where to draw the line – how do you pick and choose which patients should be refused organ transplants? If they are a recovering alcoholic, or someone who quit smoking 10 years ago, should they still be refused? Ultimately, lifestyle choices do have an effect on everyone’s health, so would refusing treatment or being pushed further down the transplant waiting list lead to those who have a bad diet or do not exercise being refused treatment too?

An innovative new technology may mean that multiple vaccinations for children could be a thing of the past. Scientists at the Massachusetts Institute of Technology have begun developing a unique, new method that could deliver multiple inoculations in just a single injection.

The advanced technology works by storing multiple vaccinations in micro particles made of a biocompatible, FDA-approved polymer. The micro particles resemble small coffee cups, which can be filled with a vaccination and then sealed with a lid. The polymer can be specifically designed to degrade at certain times, spilling out the drug from the micro particles when needed.

Researchers at the Massachusetts Institute of Technology tested the method on mice, designing the micro particles to release the different drugs at exactly nine, 20 and 41 days following the initial injection. The trials proved to be a success.

This development could mean that, if human trials prove successful, children will need just one vaccine – instead of the 15 injections they currently receive before their fourth birthday.

At present, children are typically required to receive a diphtheria, tetanus, whooping cough, polio, Haemophilus influenzae type b, and hepatitis B vaccine at eight, 12 and 16 weeks of age. This is followed by a pneumococcal injection at eight weeks, 16 weeks and one year of age, a rotavirus vaccine at eight and 12 weeks of age, meningitis type B at eight weeks, 16 weeks and one year of age, a Haemophilus influenzae type b and meningitis C vaccine at one year of age, and an MMR inoculation at one year and three years and four months of age. Children are also now given a flu vaccine as a nasal spray in autumn between the ages of tow and eight and a 4-in-1 pre-school booster at three years and four months of age.

The single vaccine could save vital NHS resources, as well as minimizing the about of jabs that children need to be safe. The new technology could also prove invaluable for children in the developing world, where there is limited access to vaccines. Usually, children in developing countries are only seen once, when they are born. This technology would mean that all their vaccinations would be covered in that single meeting.

As well as aiding in the sheer amount of childhood vaccines needed, the technology could also be a great assistance for those with diabetes or other illnesses requiring regular injections.