We set out the Abortion Act 1967 that applies in England, Wales and Scotland, considering its background, current application, recent reform of access to early medical abortion and proposals for additional reform.
This chapter considers ethical and legal developments around informed consent. The right of the patient, who is sufficiently rational and mature to understand what is entailed in treatment, to decide for themselves whether to agree to that treatment is a basic human right. The right to autonomy, to self-rule rather than rule by others, is endorsed by ethicists as a right to patient autonomy. The law has changed significantly in recent times, limiting medical paternalism and promoting patient-centred care.
This chapter considers the regulation of human fertilisation and embryology. It considers the Human Fertilisation and Embryology Acts and the role of the Human Fertilisation and Embryology Authority. It considers the regulation of treatment of people unable to have a child and assistance that can be given to those who could pass on serious genetic conditions to their children.
This chapter looks at two dimensions of consent to medical treatment. When an adult is incapable of deciding for themselves whether or not to agree to treatment, how can treatment be lawfully authorised on their behalf? If an adult refuses to agree to treatment, can that refusal be overruled, either on the grounds that the patient ‘irrationally’ refused treatment which was in their interests, or because, untreated, their physical or mental condition threatens the safety of other people?
This chapter looks at the doctrinal principles of clinical negligence. The civil law of negligence is designed to provide compensation for one individual injured by another’s negligence. Clinical negligence involves certain special factors.
In this chapter we consider the schemes by which patients seek accountability when things go wrong with their or their relatives’ treatment. We consider the interaction between mechanisms designed to provide answers and redress for patients and those that seek to ensure learning to improve patient safety. In the second part of the chapter, we consider criticisms of the tort system and alternative proposals.
How far are choices around conception, pregnancy and childbirth protected by health professionals and the law? And what legal action can parents and children take when things go wrong? This chapter explores the issues and the claims. We explore recent developments in the law relating to wrongful conception, birth and life including actions by or on behalf of children under the Congenital Disabilities (Civil Liability) Act 1976. And we look at issues relating to the protection of maternal autonomy, including the impact of the COVID-19 pandemic.
In this new chapter to the 7th edition, we examine criminal law and medical negligence, asking when a doctor’s malpractice engages criminal liability. The role of the criminal law in addressing medical malpractice is contested. The decision in the case of rogue breast surgeon Ian Paterson opens the door to an increased possibility that non-fatal malpractice may result in prosecution, eliminating the element of moral luck inherent in gross negligence manslaughter. And the recent case of Dr Bawa-Garba raises serious questions about the impact of the criminal process on healthcare practice.
The single certainty in human life is that we shall die. Death cannot be evaded, albeit it may be delayed. Medical technology has created real questions about just how we identify the threshold between dying but alive, and death itself. The development of transplantation played a major role in prompting doctors to rethink definitions of death. It would be wrong to conclude that a desire to maximise the number of viable organs suitable for transplant is the only or the most important factor in the imperative need to define the moment of death. The question is far from straightforward and a legal definition of death is required for several purposes.
In this chapter, we examine the law governing doctors’ relationships with child patients. The courts are often asked to determine the fate of sick children when doctors and parents disagree about how best to care for the child. Several recent cases (eg Gard, Evans, Haastrup, Raqeeb) attracted publicity when parents and the medical team disagreed about whether to withdraw or maintain life support for young children. Some cases involve, not disagreement between doctors and parents, but disputes between parents themselves. On the opposite side of the coin, are there limits to treatment to which a parent may agree on behalf of the child? As a child matures, common sense dictates that they be allowed to take more decisions for themselves. Gillick appeared to establish a right to adolescent autonomy. It proved to be an odd sort of ‘right’, a right to say yes but not to say no.