Does Euthanasia Have a Place in Modern Medicine?

Euthanasia is the practice of intentionally ending a person’s life in order to relieve their pain and suffering. [1] Euthanasia comes from the Greek words, Eu (good) and Thanatosis (death) and it means “Good Death”, but is it really all that good? [2]

There are different types of euthanasia:

  • Active euthanasia – a person directly and deliberately causes a patient’s death.
  • Passive euthanasia – death is brought about by an omission – i.e. when someone lets the person die. This can be by withdrawing or withholding treatment.
  • Voluntary euthanasia – a person makes a conscious decision to die and asks for help to do so.
  • Non-voluntary euthanasia – a person is unconscious or otherwise unable (for example, a young baby or a person of extremely low intelligence) to make a meaningful choice between living and dying, and another person takes the decision on their behalf.
  • Assisted suicide – where the person who is going to die needs help to kill themselves and asks for it.
  • Involuntary euthanasia – a person wants to live but is killed anyway.
  • Indirect euthanasia – providing treatment (usually to reduce pain) that has the side effect of speeding the patient’s death. The doctrine of double effect can be used to justify this type of euthanasia. This doctrine says that if doing something morally good has a morally bad side-effect, it is ethical to do it, providing the bad side-effect was not intended. This can be true even if the bad side-effect was anticipated. [3][4]

When considering the different ethical principles,”the practice of euthanasia, under some circumstances, is morally required by the two most widely regarded principals that guide medical practice: respect for patient autonomy and promoting patient’s best interests”. [5] Essentially, a patient has the ultimate say when decisions are being made about their treatment, and if a patient is in tremendous pain, it may be the most ethical thing to kill them in order to alleviate their suffering. However, these principles can be seen to contradict another ethical principle – non-maleficence – which states that a medical practitioner has a duty to do no harm or allow harm to be caused to a patient through neglect. [6] By committing euthanasia, a medical practitioner can be considered to be committing the greatest harm of all – to take away a life. Although in some circumstances, euthanasia can be considered to be the lesser evil and that there is more harm in letting a person live in insufferable pain.

Different countries have different laws on euthanasia. In the UK, active euthanasia and assisted suicide are illegal, whilst passive euthanasia is not illegal, after the Bland ruling of 1993. [7] In most countries, any type of euthanasia is illegal. There are only a few countries in which assisted suicide is legal: Belgium, Holland, Luxembourg, Germany, Switzerland and a few US states but there are variations in the legality of assisted suicide in these countries. [8]

Euthanasia has always been and will continue to be, a controversial topic. I personally believe that it is difficult for euthanasia to be a part of modern medicine. When euthanasia is accepted, the lives of people who are thought to be undesirable can be seen to be less than others. What would stop the involuntary euthanasia of disabled young babies who are considered ‘imperfect’?  Also, euthanasia may not be in the patient’s best interest, even if they have consented. For example, due to mental illnesses such as depression, which may leave a patient believing their life is worthless and that they are better off dead. In this case, euthanasia would not be the correct form of treatment. However, I do understand that euthanasia can be the most compassionate form of treatment for a patient who is in insufferable pain. In order for euthanasia to have a place in modern medicine, very strict rules and regulations would have to be implemented to ensure that no life is wrongfully taken away.

By Bernice Mangundu.


  5. Medical Ethics: A Very Short Introduction by Tony Hope

‘It’s Not Just Pain. Period’

Periods are a part of many women’s lives, and with them can come cramps, headaches and pain. However, for many women, the pain that comes with their periods is excruciating and can prevent them from living their lives normally. If you are one of these women, experiencing such painful periods, you may have endometriosis.

Endometriosis is a condition where the tissue that lines the womb (endometrium) is found outside the womb, such as in the ovaries and fallopian tubes, where it induces a chronic inflammatory reaction that may result in scar tissue. [1] It is a fairly common condition, affecting approximately 176 million women around the world. [2]

Normally, as part of the menstrual cycle, estrogen causes the lining of the uterus to grow and thicken, preparing the uterus to receive a fertilised egg. If an egg doesn’t get fertilised, the lining of the uterus breaks down. This lining then leaves the body as menstrual blood. However, in endometriosis, the endometrial tissue that would normally line the uterus is found outside it. This tissue will thicken, break down and bleed with your menstrual cycle, but this tissue and blood have no way of leaving the body. This can lead to pain, swelling and scarring. [3]

The symptoms of endometriosis include: pain in the lower tummy or back (pelvic pain), painful periods that prevent you from doing normal activities, painful ovulation, infertility (due to the changes in structure and functions of the reproductive organs),  pain during or after sexual intercourse, pain when urinating or pooing during your period,  heavy bleeding, fatigue, nausea, constipation, diarrhea or blood in your pee during your period. Endometriosis can have a huge impact on general physical health and social well being, as it makes it hard to do many things. It can also have an impact on your mental health and can lead to feelings of depression which could be due to the mental strain of coping with symptoms. [1][2][3]

If you have symptoms of endometriosis, you should see your doctor. It can be difficult to diagnose endometriosis because the symptoms can vary considerably, and many other conditions can cause similar symptoms. You will be asked about your symptoms, and an examination may be completed on your tummy and vagina, to be able to recommend the best treatment for you. If these don’t help, your doctor may refer you to a gynaecologist for some further tests, such as an ultrasound scan or laparoscopy. A laparoscopy is where a surgeon makes a tiny incision in the skin and passes a thin tube through so they can see any patches of endometriosis tissue. This is the only way to be certain you have endometriosis. A laparoscopy can provide information about the location, extent and size of the endometrial implants (abnormal growth of endometrial outside of the uterus) to help determine the best treatment options.  [1][4][5]

Currently, there is no cure for endometriosis, but there are a number of treatments that can help to manage symptoms. Treatments include:

  • painkillers – such as ibuprofen and paracetamol.
  • hormone medicines and contraceptives – including the combined pill, the contraceptive patch, and medicines called gonadotrophin-releasing hormone (GnRH) agonists and antagonists.
  • aromatase inhibitors – a class of medicines that reduce the amount of estrogen in the body.
  • progestin therapy – can halt menstrual periods and the growth of endometrial implants, which may relieve endometriosis signs and symptoms.
  • surgery to cut away patches of endometriosis tissue
  • an operation to remove part or all of the organs affected by endometriosis – such as surgery to remove the womb (hysterectomy) [1][4]

It is not yet known what causes endometriosis to occur but there are lots of theories and ideas about how it develop, including: genetics, a problem with the immune system, endometrium cells spreading through the body in the bloodstream and retrograde menstruation (when some of the womb lining flows up through the fallopian tubes and embeds itself on the organs of the pelvis, rather than leaving the body as a period). It is likely that endometriosis is caused by a combination of various factors. [1]

By Bernice Mangundu.






Man-GO Do Your Exercise

Exercise should be an important part of our daily lives. Notice that I wrote ‘should be’ instead of ‘is’, as a lot of us do not include it in our daily lives. Exercise ensures that we stay fit and healthy, but it is something that many of us neglect. We make excuses like ‘I’m too tired’ or ‘I’m too busy’ (I have used these excuses too many times). Yet we seem to find the time and energy to scroll through Instagram or watch the new episode of our favourite show. So why can we not find the time to do something that will benefit our health?

Many of us do not exercise every day, let alone achieve our recommended daily exercise. For people in my age group, (5-18-year olds) it is recommended that we exercise for 60 minutes, every day yet many of us don’t even come close to accomplishing this (if you are reading this and are not included in this age range but would like to know your recommended daily exercise, it is available on the NHS website). [1]

We need to exercise. Starting from today. Stop putting it off for tomorrow, for tomorrow never comes. You, me – we all need to stop procrastinating and exercise (so we can eat those extra fries guilt-free).

There are numerous health benefits to exercising regularly. Benefits include:

  • increase in the strength and efficiency of your cardiovascular system, which transports oxygen and nutrients around your body. When your cardiovascular system works better, you will have more stamina and energy life will become easier for you.
  • improved muscle strength as they are kept strong by their constant use.
  • joint, tendons and ligaments being kept flexible which allows for easier movement.
  • maintaining a healthy weight – the more you exercise, the more calories you burn.
  • brain function is improved as exercise increases blood flow and oxygen levels in the brain.
  • reduction of the risk of heart disease and type 2 diabetes as blood pressure and blood glucose levels are controlled by exercise.
  • improving sleep quality as physical activity causes you to be more tired, with stress and overall wellness being improved by a good quality of sleep. [1][2]

People who do regular physical activity are found to be at a lower risk of many major illnesses such as heart disease, stroke, type 2 diabetes and some cancers. [1]

Exercise has also even been found to improve mental health, helping with stress, anxiety and depression. This may be due to changes in chemical levels in the brain such as serotonin, endorphins and stress hormones. It may even provide people with a distraction or a way to release stress. [3]

Exercise doesn’t have to be painful. If you don’t like to run, don’t run! It’s not the only form of exercise. Find something you enjoy. There are countless ways to exercise: playing football, biking, weightlifting, hiking, swimming, dancing – absolutely anything. Just do something. Even if you can only spare 20 minutes of your day to exercise, that’s fine. Doing something is better than nothing.

Image result for cute mango

Man-GO exercise

By Bernice Mangundu.




Stop Disrespecting Your Home

The Earth is our home. A home is meant to be looked after and protected. Yet the Earth is not. We pollute it with harmful gases. Waste is dumped into the sea, killing countless innocent organisms, who fall victim to our actions. Trees are cut down at an alarming rate, the very organisms providing us with oxygen to breath. It is our duty as humans to care and protect it the Earth. We need to protect it for not only ourselves but for future generations. If we continue to mistreat this planet, eventually there will be nothing left to call home.

Global warming and climate change are already having a significant and costly effect on our communities and health. These effects will only continue to intensify unless we all take immediate action and improve the way in which we treat the planet.

The impacts of climate change include rising seas, changes in precipitation, higher temperatures and increases in the frequency and intensity of some extreme weather events. When it comes to heat waves and coastal flooding, the scientific evidence is clear – these extreme weather events are being caused by human-caused scientific events. Other forms of severe weather are also closely linked to climate change, this includes rises in extreme precipitation events in some regions and increasingly severe droughts in others. [1] [2]

The weather we experience, the food we consume, the water we drink and the air in which we breathe, are all affected by climate change, threatening our health. [2]

Climate change is providing longer and hotter summers.This may seem like a great thing but extreme heat can lead to heat stroke and dehydration as well as cardiovascular and respiratory problems. In extreme cases, elevated temperatures can kill, as the body is pushed beyond its limits. [3]

Extreme rainfall and flooding continue to rise in regions with rain or snow, negatively impacting the conditions people are living in. Extreme weather events such as flooding and drought can create challenges for the growth of food. [4] This can leave people without a source of income and/or hungry.

Changes in temperature, precipitation, and extreme events increase the geographic range of diseases spread by vectors, such as mosquitoes, ticks and fleas. This can also lead to the occurrence of illnesses earlier in the year. [4]

Climate change increases the risk of water-related illness due to increases temperature, more frequent heavy rains and the effects of storms. Gastrointestinal illness like diarrhoea, effects on the body’s nervous and respiratory systems, or liver and kidney damage can occur due to the consumption of unsafe water. Climate impacts can affect exposure to waterborne pathogens. Flooding resulting from increases in extreme precipitation may contaminate bodies of water such as beaches, lakes and sources of drinking water. [4] 

The quality of the air in which we breathe is decreasing as it becomes more polluted. This can lead to asthma attacks and other respiratory and cardiovascular health effects. Wildfires, which are increasing in both intensity and frequency, also create harmful air pollutants, which further decreases the quality of air. [4]

The effects of climate change are slowly but surely destroying the planet. And as the planet deteriorates, so does our health. This is due to climate change affecting human health in two main ways: first, by changing the severity and frequency of health problems that are already affected by climate factors; and second, by creating unprecedented health problems or threats in places or times of the year where they have not previously occurred. [4]

Some populations are especially vulnerable to climate health risks due to sensitivities, high likelihood of exposure, low adaptive capacity, or combinations of these factors. People in society who are more likely to be at risk from the effects of climate change are the elderly children, pregnant women and people with disabilities. [4]

People living in developing countries are more vulnerable to climate change’s effects, compared to those living in wealthier countries. This is because they do not have the resources to properly prepare themselves for extreme weather conditions or rebuild their communities after the occurrence of extreme weather events such as hurricanes. This is highly unfair considering that most pollution is created by these wealthier countries but people in developing countries experience climate change’s effects more heavily.

It doesn’t take much for you to help the planet. Little things like recycling more, having quicker showers and switching off light switches when you leave a room can help. If we all do a little bit to save the planet, it will mean a lot. But if we do nothing and continue to disrespect our planet, our future on Earth is at risk.

By Bernice Mangundu.



‘Just One More Drink’

Alcoholic beverages are consumed every day by countless amounts of people. Ethanol is a psychoactive substance which is present as the active ingredient in alcoholic beverages such as beer, wine and distilled spirits. It is one of the oldest and most commonly used recreational substances. In low doses, alcoholic drinks can reduce anxiety and increase sociability but in higher doses, it can cause intoxication and unconsciousness.

There are several reasons why people consume alcohol. People may drink to relieve the stresses of everyday life such as work, relationships or money. Some people, especially teenagers, may feel obligated to drink due to peer pressure, in order not to feel left out or ridiculed by others. The consumption of alcohol also tends to be fun for many people. Alcohol’s drunk effect makes people feel happy and drinking it with friends can be a fun experience. If a person is nervous in a social situation, drinking helps them to relax and have more fun. However, what happens when the use of alcohol is no longer beneficial?

This is Sophia’s story.

Alcohol had always been a part of my life. As I was growing up, my parents would occasionally drink a glass of wine. If they were feeling generous, they would let me have a sip or two. By high school, I was drinking with my friends at parties. I have a few embarrassing drunk stories from these parties, but then who doesn’t? As I got older I would still drink with my friends on a girl’s night out or night in. I would even drink a glass of wine on a stressful day.

But the glass of wine I would have in the evening of a stressful day was no longer enough. I would need a second glass to relax. Until it slowly became a third glass, leading to a fourth and eventually, the whole bottle. Soon every day became stressful. There were piles of paperwork all over my desk, bills to pay and rent to worry about. I was struggling to cope. So my solution was to drink a bottle of wine every evening.But the evening just couldn’t arrive quick enough, so I carried a small flask of vodka with me to work.  I needed a way to cope during the day.  Until I could no longer carry a small flask to work anymore because I’d been fired for being intoxicated one too many times.

The nice person my friends used to know was slowly replaced with someone distant, irritable and quick to anger. My friends voiced their concern about my drinking and tried to help, but I refused to believe I had a problem. I mean, it’s not like they didn’t drink either. It’s just that their ‘one more drink’ would always be just that, but mine never was. They eventually stopped inviting me to social situations. I guess it was in the fear that I would embarrass them in my drunken state. Soon my friends became strangers as they actively avoided me. So, strangers in the bars I would frequent became my friends. They didn’t judge me or my drinking. They didn’t judge me when I would say, ‘‘just one more drink’’ despite it never really being one more. Yet they were still just strangers. The only ‘friends’ I had left were the empty bottles of wine that littered my apartment. An apartment I could’ve lost due to an addiction. An addiction that cost me my job, friends even my health. Luckily it hadn’t cost me my home, but it could’ve if I had reached for help any later.

My use of alcohol started as a simple escape but slowly became my biggest problem.

There are many people with stories, like Sophia, of their battle with alcohol abuse. Alcohol abuse can be a severe problem which can lead a person to lose their job, home and ruin relationships with friends and family. Regular heavy drinking may also lead to health problems such as fatigue, memory loss, liver diseases, heart problems, diabetes, mental illness and cancer.

In most parts of the world, alcohol is legal for adults to purchase and consume. As a result, alcoholic beverages are widely available. Since use is so common, it might seem hard to determine who is drinking alcohol in an appropriate manner and who is drinking in a manner that could lead to alcohol abuse or alcoholism, especially because alcoholics can be secretive about it. Alcohol abuse is one of the oldest problem’s in humanity, with alcoholism being the most severe form of alcohol abuse as it involves being unable to control drinking habits. When alcohol consumption becomes out of control it can be detrimental to a person’s life. If someone close to you is showing any of the following signs, it may be that they’re suffering from alcoholism:

  • A lack of interest in previously normal activities
  • Appearing intoxicated more regularly
  • Needing to drink more to achieve the same effects
  • Appearing tired, unwell or irritable
  • An inability to say no to alcohol
  • Anxiety, depression or other mental health problems
  • Becoming secretive or dishonest

If a person seems to be experiencing some of these symptoms, they may require help. The first step of treating alcoholism is acknowledging that there is a problem. As with many health problems the second step is to seek help from a healthcare professional, like a local GP who can refer you to a specialist. If this is not the route a person wants to take, other options are available such as trying the many alcohol support services accessible to them.

There needs to be less stigma around alcoholism because it’s a problem that affects many people, whether it is personally or someone they know. It is something that can happen to anyone at any time.

By Bernice Mangundu.


The Journey of Women in Medicine

In honour of celebrating all the strong and powerful women in the world, on international women’s day on the 8th of March, I will be exploring the battle women have faced becoming respected in the medical field.

In the face of adversity, women have always been resilient and strong, pushing for change in the way they are treated and the prejudice they are faced with. They have fought and struggled to prove their strength and intelligence. In the late nineteenth century, women were finally accepted as medical practitioners, but it was not an easy journey.

Women have always been intimately involved in medical matters, from the ancient to the modern world. There have been several roles women have played. Women have worked as midwives, nurses, apothecaries and bone-setters. But as the study of medicine became formalised, women were increasingly being excluded from the narrative. In the 14th century, King Henry VIII was quoted as saying “No carpenter, smith, weaver or women shall practise surgery.”  When governments declared that only those trained at universities could practise as doctors, women were forbidden from this training.

In her pursuit to break into the medical profession, Margaret Ann Bulkley went to the lengths of adopting a male persona to be accepted. She successfully pulled it off and she became fully qualified as Dr James Barry in 1812 from Edinburgh University. From there this ‘’beardless lad’’ went on to have a distinguished career as a skilful British army surgeon for more than 40 years. Barry developed a reputation for her surgical prowess and commitment to improving conditions for soldiers and the local population. Barry was so successful at maintaining her deception that it was only when she died of dysentery in 1865 that her secret was discovered. Despite her skill, her gender made her an embarrassment to both the war department and medical association. Therefore, these findings were kept hidden and Dr Barry was officially buried as a man.

By the mid-19th century, more women were demanding entry to medical school. At the time, women were still considered intellectually inferior and weaker than men. Men expressed concerns that exposure to gore might pose a risk to, what they considered, delicate female health. However, women were exasperated with the prejudice they faced and started to fight back, such as Elizabeth Garrett Anderson or Elizabeth Blackwell.

Dr Elizabeth Blackwell was the first female physician in the United States. Blackwell applied, and was rejected, by many schools. Yet she persisted, until she eventually gained admission to the Geneva College of Medicine, by a mere accident. To show his liberalism, the dean had presented the application directly to his students, asking whether a woman should be allowed to attend the classes. Much to the dean’s surprise, the students, thinking it a great joke, voted unanimously to admit her. She managed to gain a medical degree in 1849 and set up the New York Infirmary for Poor Women before returning to England, where she was accepted into the Medical Register in 1858. Despite a flood of protests within the medical community, other women soon followed suit, notably among them Elizabeth’s younger sister, Emily Blackwell, as well as Maria Zakrzewska, Mary Putnam Jacobi and Ann Preston.

Elizabeth Garrett Anderson was the first English woman to qualify as a doctor. Not a single British medical school, that she applied to, would accept her. Through determination and perseverance, she managed to practice medicine by exploiting a loophole and sat exams for the Society of Apothecaries in 1865, going on to set up the Dispensary for Women. She was the last woman to study medicine through this method as the following year it was blocked. This is due to male doctors’ opposition to female doctors and each time a loophole was found that allowed them to progress in the medical profession, the rules would be changed to prevent it from happening again.

Anderson went on to campaign about women’s involvement in medicine, contributing to the 1876 “Enabling Act” that allowed the licensing of both male and female doctors. Unfortunately, this did not change the antagonistic attitudes of most British medical schools towards women. But did that stop women? Of course not, they just opened their own doors, setting up their own schools and hospitals. In 1874, a group of determined and pioneering women, including Elizabeth Garrett Anderson and Sophia Jex Blake, established the first medical school in Britain to allow women to graduate and practise medicine. This was the London School of Medicine for Women. The coming decades saw more and more medical schools accepting women, and in 1892 the British Medical Association finally accepted female doctors.

Today, female medical students outnumber their male colleagues and there are numerous qualified female doctors practising in the UK, America and all over the world. Although the progress made to get to this point has been outstanding, women still have more progress to make before equality is reached. Female doctors, on average earn 1/3 less than their male counterparts, are significantly under-represented in some specialities, particularly surgery, and there are very few women in senior clinical academic positions.

The journey is not yet over.

Women’s involvement in medicine has been accompanied with disapproval and at times, outright antagonism. This has meant that the medical profession has been dominated by men for most of its history. But throughout, women have persisted and found the strength within them to fight for their right to practice medicine.

By Bernice Mangundu.


The Silent Killer

In the UK, our love for sugar may slowly be killing us. Although sugary foods taste good in our mouths, they are not that good for our bodies. Our unbalanced diets, love for Netflix and heavy drinking are causing more harm than good. This is because they all increase the risk of getting diabetes.

There are two distinct types of diabetes, type 1 and type 2. Type 1 diabetes is when the pancreas has stopped making insulin because the body’s immune system attacks the cells that produce this insulin. Type 2 diabetes is when the body doesn’t produce enough insulin or the cells within the body do not react to insulin. Approximately 90% of people who have diabetes have type 2 diabetes. This is a worrying percentage because this type of diabetes is self-inflicted.

Over 3 million people in the UK have diabetes. Unfortunately, this number is steadily rising. This rise is due to an increase of people with obesity, high blood pressure, having unbalanced diets and living sedentary lifestyles. There are also many people living their lives, unbeknownst that they have this condition. This is a huge problem because uncontrolled diabetes can lead to various of complications which include: heart disease, kidney disease, strokes and vision loss.

In recent years, there has been a worrying increase of children being diagnosed with the condition. This is likely due to a love of all things sweet and the ease in which children can get them. Children need to be encouraged to eat more fruits and vegetables as well as play more sports and watch less TV. There is also the very serious problem of children having the disease but being unaware of it. This means children with diabetes are growing up without the knowledge that they have it and therefore cannot treat their condition. When they are finally diagnosed many years later, it may be too late.

To prevent the development of diabetes, it is important to eat a healthy, balanced diet, exercise regularly, maintain a healthy weight and drink alcohol in moderation.  It is very difficult to revert type 2 diabetes, so its prevention is vital since having the condition puts a person’s life at risk.

Prevent diabetes before it kills you.

By Bernice Mangundu.

The Making of a Medic

I am Bernice, a 17-year old facing the many challenges of school life. One of these challenges used to be the seemingly simple question, ‘what do you want to be when you are older?’. Whenever teachers or relatives would ask this question, I would become filled with uncertainty and anxiety. I would ask myself, ‘what do I want to do?’ The answer to this question has changed as frequently as it has been asked, over the years.  I’ve wanted to be a teacher, an artist, a fashion designer, an engineer and a plethora of other jobs. This question about my future used to be difficult to answer, but not anymore.

I am now certain about the career path I want to take. No longer does this question about my future fill me with anxiety or worry. There is no hesitation when I respond with, ‘I want to go into medicine’.

A medical career has always been an idea that I’ve considered. I became certain about it when one day, a friend and I were talking about the jobs we wanted when we were older. I listed a few different jobs that interested me, including going into medicine, to which my friend replied with, ‘ I could see you as a doctor’. This made me think, ‘could I see myself as a doctor?’ The answer was and still is, yes.

Taking a medical degree will enable me to gain knowledge about so many fascinating topics and use that knowledge for a great power – the power to help others. The ability to help people in ways that others can’t is a remarkable opportunity that I am determined to work hard for.

I have completed extensive research about what becoming a doctor entails. Though the high entry requirements and tough competition to get into medicine do intimidate me, I am determined to work hard to achieve my desire to go into the medical field.

Though the journey may not be easy, I will become a doctor.

By Bernice Mangundu.