Search results
demonstrated that this was not a valid test for all purposes: elective cardiac arrest during openheart surgery, for example, or cases of spontaneous cardiac arrest followed by successful resuscitation. The heart stops but the patient is not dead. Machines such as mechanical ventilators or respirators have effected major improvements in techniques of resuscitation and life support for those who are desperately ill or injured. Where these efforts are successful and the patients recover, one may praise the advances in medical techniques. Sometimes such measures do not provide
5.1 There would be little support today, even from the most paternalistic doctor, 1 for the proposition that a sick adult should be compelled to accept whatever treatment his doctor thought best. No one suggests that adults who stay away from dentists out of childlike fear and to the detriment of their dental and general health should be rounded up and marched to the nearest dental surgery for forcible treatment. Few would deny the right of the adult Jehovah’s Witness to refuse a blood transfusion, 2 even if in doing so she forfeits her life. Medical
decisions to withhold or withdraw treatment (even when agreed with parents) could subject them to possible criminal liability for murder or manslaughter. The fundamental principle governing withholding life saving treatment from young children was settled in Re B in 1981. An infant girl, Alexandra, was born suffering from Down’s syndrome and an intestinal obstruction. In a normal child, simple surgery would have been carried out swiftly with minimal risk to the baby. Without surgery, the baby would die within a few days. Her parents refused to authorise the operation
conflicting priorities. For example, two major road accidents take place in the same city at the same time as a winter ‘flu’ epidemic. The elderly ‘flu’ patient, whose call is given lower priority than the crash victims, is still owed a duty by the ambulance service. In the circumstances, there may be no breach of duty because, confronted by competing demands, the ambulance service responded reasonably. Would delay by a hospital in arranging treatment breach the duty of care? If a patient is seen at an out-patients clinic and then waits so long for surgery that her cancer
current law. What of a patient offered a hip replacement on the NHS whose operation is contracted out to a private hospital, or independent treatment centre? This may happen when the NHS hospital trust to which she is referred contracts with a private sector hospital to carry out surgery on its behalf, often to deal with a backlog of operations, or her CCG arranges her care in the private sector. If her treatment is carried out negligently, one option is to sue the private provider. But can she sue the NHS trust which despatched her to the private sector, or
cardiac surgery, the pathologist might lawfully remove and retain his heart until it was possible to ascertain why the infant died. However, there was no power to retain organs for research or teaching purposes. Once the cause of death was established, neither the coroner nor the pathologist had any further legal power to retain body parts. Such ‘material’ should have been disposed of, unless the relatives of the deceased authorised retention for research or teaching purposes. In practice, coroners simply allowed pathologists to do what they wished with human material
livers and engineering tissue based on collagen matrices to support tissue regeneration for skin grafts, ligaments and bone. Babies born at ever earlier stages in gestation, or born with severe abnormalities, can be offered a chance of survival by amazing developments in neonatal intensive care. Some forms of fetal handicap are correctable by surgery carried out while the baby is still in the womb. Transplant surgery saves kidney, liver and heart patients from certain death. New ‘smart drugs’ to enhance cognition raise questions about whether enhancements are
within the NHS, are performing functions of a public nature and face potential claims under the Act (although normally such claims would be brought against their employer). GPs and other non-employed NHS personnel might be more directly in the firing line. Professionals in private practice and private hospitals raise tricky questions. While a doctor is a public authority in relation to their NHS functions, the same does not apply to doctors in private practice. So if patient A contracts with Dr B to carry out surgery at Clinic C paying out of his own pocket, or via
of certain surgery and therapy would be excluded. At one level, the patient could obviously not recover compensation for pain and suffering ordinarily attendant on surgery. At another level, unpleasant and dangerous side effects, for example, the patient’s hair falling out during chemotherapy, or the risk of a stroke in some forms of brain surgery, would have to be excluded if they were inescapable in the pursuit of proper treatment. One important proviso is attached to the exclusion of unavoidable side effects from compensation. The patient must have been properly
such surgery than their peers. 9 The Bristol Inquiry 10 uncovered a ‘club culture’. 11 Staff were caring and well motivated, but care was badly organised; the standard of care was poor and there was a lack of effective communication. In Bristol, and in Liverpool, 12 evidence emerged of hospitals retaining children’s organs without their parents being told that only parts of their children’s bodies were returned to them for burial. Subsequently, it became apparent that organ retention in relation to children and adults was a widespread practice. 13 Harold Shipman