Embryo research, cloning, assisted conception, neonatal care, saviour siblings, organ transplants, drug trials – modern developments have transformed the field of medicine almost beyond recognition in recent decades and the law struggles to keep up. In this highly acclaimed and very accessible book Margaret Brazier and Emma Cave provide an incisive survey of the legal situation in areas as diverse as fertility treatment, patient consent, assisted dying, malpractice and medical privacy. The sixth edition of this book has been fully revised and updated to cover the latest cases, from assisted dying to informed consent; legislative reform of the NHS, professional regulation and redress; European regulations on data protection and clinical trials; and legislation and policy reforms on organ donation, assisted conception and mental capacity. Essential reading for healthcare professionals, lecturers, medical and law students, this book is of relevance to all whose perusal of the daily news causes wonder, hope and consternation at the advances and limitations of medicine, patients and the law.
The international growth and influence of bioethics has led some to identify it as a decisive shift in the location and exercise of 'biopower'. This book provides an in-depth study of how philosophers, lawyers and other 'outsiders' came to play a major role in discussing and helping to regulate issues that used to be left to doctors and scientists. It discusses how club regulation stemmed not only from the professionalising tactics of doctors and scientists, but was compounded by the 'hands-off' approach of politicians and professionals in fields such as law, philosophy and theology. The book outlines how theologians such as Ian Ramsey argued that 'transdisciplinary groups' were needed to meet the challenges posed by secular and increasingly pluralistic societies. It also examines their links with influential figures in the early history of American bioethics. The book centres on the work of the academic lawyer Ian Kennedy, who was the most high-profile advocate of the approach he explicitly termed 'bioethics'. It shows how Mary Warnock echoed governmental calls for external oversight. Many clinicians and researchers supported her calls for a 'monitoring body' to scrutinise in vitro fertilisation and embryo research. The growth of bioethics in British universities occurred in the 1980s and 1990s with the emergence of dedicated centres for bioethics. The book details how some senior doctors and bioethicists led calls for a politically-funded national bioethics committee during the 1980s. It details how recent debates on assisted dying highlight the authority and influence of British bioethicists.
While she became associated with British bioethics following her
engagement with IVF and embryo research in the 1980s, Mary
Warnock is better known today for her views on euthanasia.1
Warnock first engaged with this issue in 1993, when she was
appointed to a House of Lords Select Committee that investigated
whether there were circumstances in which ‘assisteddying’ might
be permissible, when a doctor would not be prosecuted for ending
a patient’s life or helping them end their own lives. After deliberating for a year, Warnock and her fellow committee
19.1 Society has never been comfortable with issues surrounding the process of dying; and as healthcare staff are involved with the dying, they inevitably become involved in ethical as well as medical dilemmas. 1 For the last few years the heat of the debate has focused on when the law should permit some sort of assistance for those who help a terminally ill relative or friend end her life, in particular when families have travelled with a relative to the Dignitas clinic in Switzerland where assisteddying is not unlawful. But this is just one of a host of
An exploration of the role of autonomy in the debate about assisted suicide
autonomy has intrinsic value, but for others, autonomy is just one value among
others and it may or may not be accorded prominence in any given debate.
The role of autonomy in arguments opposing the permissibility of assisteddying
Opponents of assisteddying who invoke the concept of autonomy tend to
deploy one of two strategies: the first is to diminish the value of autonomy
by reducing it to a need for control or to what Onora O’Neill refers to as
‘mere, sheer choice’. In her testimony to the Commission on AssistedDying,
roadly conO’Neill distinguished various
covered in the course of a day. On 26 May 2016, for example, there were two long debates in the chamber, one on special educational needs and disabilities in schools and the other on ensuring equal access to mental health and physical healthcare; in between the two there was a short debate on young voters in the EU referendum.
The debate function encompasses an agenda-setting role. Although many subjects of debate may have been considered before, some may be coming on to the parliamentary agenda for the first time. A good example is the Patient (AssistedDying) Bill
groups. Teaching ethics, once a matter of professional etiquette,
takes place on dedicated courses and in specialised departments that
emphasise law and moral philosophy. A growing body of interdisciplinary journals considers topics that were once confined to the
correspondence pages of the Lancet or the British Medical Journal.
And public discussion of issues such as embryo research, cloning,
genetic engineering or assisteddying are now as likely to be led by
a lawyer or a philosopher as a doctor or a scientist.
This new approach is known as ‘bioethics’: a neologism
, social deprivation, domestic
violence, immigration or ETA terror but with a deeply controversial ethical
issue of much wider resonance: euthanasia and the legalisation of assisteddying, as exemplified by the real case of the Spanish quadriplegic
Sampedro spent many years trying to persuade the Spanish
judicial system to de-criminalise assisteddying so that his own GP could
offer him a
Margaret Brazier 121
or assisteddying. He pays a heavy price sometimes. He has been hounded
by some of the media, condemned as a ‘baby killer’17 and prevented from
speaking in Germany on at least one occasion.
Reflect for a moment on Harris’s views on embryos, fetuses and neonates.
His logic is hard to fault and paradoxically is shared by those who may
reach a diametrically opposite conclusion to Harris in relation to the moral
status of the unborn or newly born human.18 Much ink has been wastefully spent on asking when life begins. Eggs and sperm are
penalty on their
statute books, but nineteen, in addition to Washington DC, do not.
Some states that have the death penalty, most notably Texas, carry out executions on a regular basis. In
others in practice they do not happen, or at least are a very rare
occurrence. As of mid-2018, marijuana was legal in nine states for
recreational purposes and legal for medical reasons in thirty.
Assisteddying is legal in some jurisdictions: following a
referendum in 1994, Oregon passed the 1997 Death with Dignity Act