A unique view of ethics

19 September 2003

Miles Little, Emeritus Professor in Surgery, has endured a trying few months: colleagues whispering behind his back, private conversations behind closed doors.

Finally three of Professor Little's colleagues from the University's Centre for Values, Ethics and the Law in Medicine revealed the reason for their furtive behaviour. They had been compiling, without his knowledge, a compilation of his writings, A Miles Little Reader - Restoring Humane Values to Medicine.

Ian Kerridge, a co-editor of the Miles Little Reader and an associate professor in bioethics, describes Professor Little as a mix of surgeon, poet, philosopher and humanist.

"From an intellectual perspective, Miles takes a unique approach to thinking through problems with ethics and medicine," he said. "He's constantly saying, 'Let's stop and think about what it is that medicine is trying to do; who are we? And how does medicine fit into society?'"

Justice Michael Kirby writes in the foreword: "We must not neglect the hands-on need to respect human rights and human dignity and promote equity, peace and justice at the level of the individuals with whom we deal. This is the approach that Miles Little has taken to values, ethics and law in medicine."

Professor Little describes the loss of his sister, aged only 32 as the catalyst for his quest to practise medicine with compassion, empathy and ethical and moral awareness.

"In the early 1960s, all of my close family - my mother, father, grandmother, stepfather, uncle and sister - died within two years of one another," Professor Little says.

"It was probably my sister's experience that really made me question a lot of what I'd been taught. She had bowel cancer, which was missed by a series of doctors. When it was eventually diagnosed, it had spread to her liver. She had a palliative operation, but she wasn't told anything - that was the convention then.

"I was a surgical resident at Prince Alfred. Three weeks before she died, she was past being bitter. But she was still angry she hadn't been told what would happen. She said she would have lived the last eleven and a half months of her life differently. She said to me: 'If you ever do this to one of your patients, I'll come back to haunt you'. It was a terrific object lesson in questioning the conventional system; in learning to better communicate and spend time with people, cultivating honesty as well as you possibly could."

Today, Professor Little acknowledges the medical profession has changed. "Now you get incredibly complex ethical and moral questions in the system to do with turning off respirators, how to tell someone about their circumstances; profound questions about handling ethnic issues - even whether it is culturally appropriate to use certain words, such as 'cancer'."

A Miles Little Reader: Restoring Humane Values to Medicine ($39.95) is edited by Ian Kerridge, Christopher Jordens and Emma-Kate Sayers from the Centre for Values, Ethics and the Law in Medicine. It is published by Desert Pea Press.