The authors' aim is to bring to the attention of readers the inadequacies of care for people in Hungary who are terminally ill. They believe that both objective and subjective factors cause these inadequacies. Most of these factors arise from moral dilemmas that could be eased or even solved if ethics education had a much more prominent place in the nursing curriculum. Even if nurses would not become automatically better persons morally, a much wider knowledge of medical/nursing ethics could significantly improve nursing care both before and at the end of life. Although the article is also critical of the nursing care provided, it is not its purpose to make any generalizations. The study utilized selected passages from essays written by 76 practicing nurses on their personal experience of ethical dilemmas in their work environment, and a questionnaire administered to 250 students (registered nurses and health care students) studying for a college degree. This article is written by two authors who have formed an unusual alliance: a registered nurse with 29 years' experience of bedside nursing, but who is currently a teacher of nursing ethics at a local health college, and a lawyer turned bioethicist.

Medical ethics in Hungary has finally moved beyond arguments over tipping and bribes to discussions of euthanasia, confidentiality, truth-telling, and informed consent. Ethics committees have been formed at the local and national level, and medical schools are beginning to take seriously the systematic teaching of medical ethics. In some quarters, however, old attitudes persist. Among older doctors paternalism reigns supreme, and law-makers continue to ignore international ethical guidelines.

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The author attempts to give a general picture of corruption, especially in the area of healthcare. Corruption ranges from fraud, through deceit, bribery and dehumanisation, to immeasurable moral decay. As a bioethicist who has challenged corruption in various ways, the author approaches this worldwide plague mainly on the basis of his personal experience. He does not offer a recipe for successfully combating corruption, but tries to provide some ways and means to fight immorality without self-defeat. Bioethics is not a discipline whose task is to investigate, expose, or punish corrupt people. A number of agencies exist for this "noble" job. Nevertheless, an ethics teacher should not be completely indifferent to obvious and harmful immoral behaviour, regardless of his/her personal compulsions. It is not the "patient rights" that threaten the prestige of the medical profession; it is rather the bad apples that infiltrate the moral mission of this esteemed work. It seems that the hardest challenges in the struggle against corruption are bad laws-laws that provide loopholes and immunity to immoral dealings. In a stable, strong democracy, morally unfounded laws can, and will be changed. Where real democracy exists, they would not even have come into effect.

Hungarian medical ethics committees were established at the end of the 1950s. They came into being on the Communist Party's initiative. They could hardly be called "interdisciplinary" since their membership was made up of high-ranking physicians and a few head nurses. Their main task was to counter the practice of "tipping." Medical ethics and "tipping" were practically synonymous. These committees did not confront or try to resolve ethical problems concerning such issues as patient rights, informed consent, refusal of treatment, human experimentation, abortion, etc. These committees - whether it is believable or not - belonged to the Physicians Health Workers Trade Union. They were under the guidance and supervision of this social organization. The public was excluded from their meetings, and the committees' duty was to follow the health laws which were supposed to have given excellent ethical guidance. Even in a textbook on medical ethics used at one of the medical universities, written by a psychiatrist, the health laws were presented and explained back and forth. Of the 88 pages only 23 dealt with morals in general and the Hippocratic tradition. The Hungarian National Health Service as well as its medical ethics committees are similar in many respects to the Soviet and Eastern European countries' health care system and ethics committees. Since radical changes have taken place in these so-called "former" communist countries, it can only be hoped that these committees will eventually develop into groups who will deal directly with the moral questions or medicine and health care.