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A report of a problem-based learning project on the ethics of terminal care, offered as one of the options available to first year MB ChB students in Edinburgh University Medical School. The project formed part of the 'clinical correlation course' in the new curriculum. Six students took part under the supervision of two clinical tutors and a moral philosopher. The course was case-based and practical with students being given the opportunity over a period of eight weeks to meet patients, relatives and hospital staff at a local geriatrics hospital and terminal care home. The main issue studied was the degree of choice available to patients electing to be treated at home, in hospital or in a hospice. Other issues included: pre-death, disposal of the dead, certification of death, communication with relatives and follow-up bereavement services.

Two hundred admissions to a local-authority Residential Home in Edinburgh were followed up for four years to study subsequent morbidity and mortality in the Home or after transfer. Their survival was compared with that of patients transferred from a Geriatric Assessment Unit to Long-stay Units. The mortality of both groups was greater than expected, particularly in the early weeks and in those suffering from cerebrovascular disease.