Medical ethics column basics: Tips from a BMJ columnist

In 2007, the editor of the British Medical Journal offered me a column on medical ethics. The BMJ, founded in 1840, is one of the world’s leading medical journals. Its readers are mostly doctors and come from a vast array of countries and medical specialties.

Over the next 10 years, I have written 80 or so pieces, with topics ranging from the ethics of cosmetic surgery to commentaries on high profile cases, such as Ashya King, Charlie Gard and Alfie Evans. Below are a few tips for aspiring writers of a medical ethics column.

Writing a medical ethics column: Get stuck into the subject matter

There is no better way to obtain the ideas and anecdotes for a column than immersing yourself in the subject matter.

So if you can, get ‘stuck in’. Shadow doctors in hospitals. Watch some operations. Go to the morgue to observe post-mortems. Sit in with a GP. Spend time with an ambulance crew. It will give you ideas, help your writing sound authentic, and enhance your credibility among readers.

I have the added advantages of being married to a doctor (one with little interest in medical ethics) and practising law in the field of clinical negligence, with almost daily experience of poor medical care. I joke that the columns are atonement for spending my days suing doctors.

Tell stories in your medical ethics column

A successful column on ethics or law, like a good lecture, should usually include a story, preferably a real-life case or a personal anecdote. When I was a lecturer in medical ethics, I kept cuttings of stories that could be used in teaching. The Journal of Clinical Ethics and the Journal of Hospital Ethics are good sources of case studies. So too are conferences such as the forthcoming International Conference on Clinical Ethics Consultation (21^st – 23^rd June 2018, in Oxford). I last attended the conference in 2016 and wrote a column based on the experience. It is available here:

If you get ‘stuck in’, stories and anecdotes will follow. The story in the column should be compelling but short, otherwise too few words remain to draw the link between the story and the message.

Give something

There must be a clear message. Or a take-home point. Or, best of all, an “aha” moment.

In the 600-word medical ethics column, I try to give advice that will help doctors improve their practice or stay out of trouble. They are the more popular columns; the ones when the reader goes “that could have been me!” or “I also do that!”. When in a more philosophical mood, I write a piece that, I hope, will set thought in motion. Those leave me open to accusations of being “too philosophical” or lacking relevance to clinical practice – readers who teach medical students will know the feeling – but they act as a counterpoint to the more practical pieces.

Medicine is a broad church and keeping everyone happy is impossible. The columns are “too surgical”, “too legal”, “too philosophical”, or “too focused on acute care”. Again, this is a familiar criticism to those working in the field of bioethics, where no one is qualified in all the relevant disciplines of philosophy, law, sociology, medicine, theology, and so on. Do not let it get you down.

Keep your medical ethics column short

For the first few years, the word limit for the column was 850. It is now 600, slightly shorter than this blog.

Although frustrating, the 600-word limit is a blessing. The French poet Baudelaire once said of the sonnet: “parce que la forme est contraignante, l’idée y jaillit plus intense’ (“because the form is restrictive, the idea springs forth more intensely”). Your initial manifold ideas for the column must be whittled down to 1 or at most 2 per column. The self-editing process sharpens the mind and trims weaker content that would have found its way into a longer piece. There is no padding.

Medical ethics columns are endlessly interesting and practically relevant. There should be more ethics columns in medical journals.

Daniel Sokol’s forthcoming book ‘Tough Choices: Stories from the Frontline of Medical Ethics’ is out in October 2018. It is available for pre-order here.

Daniel Sokol, lawyer and medical ethicist, has just been shortlisted for the ‘Best Columnist of the Year (Consumer Media)’ award at the PPA Awards 2018 (“the Oscars of the UK publishing industry”). In 2015, Daniel won ‘Best Column’ at the UK Medical Journalists’ Association Awards. In this article, he gives aspiring medical columnist some tips for success.

Follow @DanielSokol9 on Twitter here.