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Varsity Medical Ethics Debate 2019: is authoritarian government the route to good health outcomes?
  1. Azmaeen Zarif1,2,
  2. Rhea Mittal1,3,
  3. Ben Popham1,4,
  4. Imogen C Vorley5,6,
  5. Jessy Jindal5,6,
  6. Emily C Morris5,6
  1. 1 University of Cambridge School of Clinical Medicine, Cambridge, UK
  2. 2 University of Cambridge Gonville and Caius College, Cambridge, UK
  3. 3 University of Cambridge Peterhouse College, Cambridge, UK
  4. 4 University of Cambridge Robinson College, Cambridge, UK
  5. 5 Oxford University Medical School, Oxford, UK
  6. 6 University of Oxford Green Templeton College, Oxford, UK
  1. Correspondence to Azmaeen Zarif, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SP, UK; az397{at}


Authoritarian governments are characterised by political systems with concentrated and centralised power. Healthcare is a critical component of any state. Given the powers of an authoritarian regime, we consider the opportunities they possess to derive good health outcomes. The 2019 Varsity Medical Ethics Debate convened on the motion: ‘This house believes authoritarian government is the route to good health outcomes’ with Oxford as the Proposition and Cambridge as the Opposition. This article summarises and extends key arguments made during the 11th annual debate between medical students from the Universities of Oxford and Cambridge. By contrasting the principles underlying authoritarianism and democracy, it enables a discussion into how they translate into healthcare provision and the outcomes derived. Based on the foundation of said principles, an exploration of select cases represents examples of applications and the results. We analyse the past, present and future implications on the basis of fundamental patient-centred care.

  • quality of health care
  • politics
  • morals
  • public policy

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  • Contributors AZ planned and wrote the manuscript, which was based on arguments generated in discussion between AZ, RM, BP, ICV, JJ and ECM. All authors reviewed the manuscript and approved the final draft. AZ is the guarantor of this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note The inaugural Varsity Medical Ethics Debate in 2008 continued the centuries-old rivalry between the Universities of Oxford and Cambridge and has run since then as an annual event hosted alternately at the respective Unions. This year The Cambridge Union played host to the 11th annual debate, with an audience of medical students, doctors, and academics in attendance. After very persuasive arguments from both sides, the judges awarded victory to the Cambridge team (Opposition) this year, who focused on the human cost of authoritarianism and the implications on health outcomes as a result. Both sides enjoyed a wide-ranging and thorough discussion of a very interesting motion.

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