When should the law permit assistance for those who seek to end their lives? When, if ever, should attempts may be made to hasten death when there is excessive suffering and when the cause is hopeless (euthanasia)? These issues are examined in Chapter 19 on the End of Life. We examine key cases from the European Court of Human Rights (including Pretty v UK) and domestic courts (including R (Purdy) v DPP and the recent Nicklinson litigation). We look at legislative proposals on physician assisted suicide (PAS) and assisted dying. In the second half of the chapter we consider whether efforts always be made to keep a dying person alive in spite of the additional suffering incurred by that person and the cost in terms of human dignity. We examine cases dealing with patients in a persistent vegetative state (PVS) such as Airedale NHS Trust v Bland, and the developing law on end of life questions for those in a minimally conscious state.
This chapter focuses on the regulation of Healthcare Research. If medicine is to progress to combat cancer and continue the battle against diseases such as diabetes and multiple sclerosis, new drugs and procedures must be subject to trials. But patients must not be used as a means to an end. We consider the role of Research Ethics Committees in balancing the risks and burdens of research and set out the law relating to consent, children, those lacking capacity and emergency research. Compensation is considered and we consider the legal response to research misconduct.
Having considered transplantation in Chapter 17, in ‘The Human Body and its Parts’ we examine how English law regulates the removal, retention and uses of human body parts and we consider how far (if at all) we own our own bodies. We examine the relevant provisions of the Human Tissue Act 2004 and the role of the Human Tissue Authority. In addition we address some aspects of the role of the coroner; a key actor in the regulation of the use of bodies and body parts post mortem.
The patient wishing to claim clinical negligence faces a number of problems. How can a lawsuit be funded? Which health professional caused the injury? As a result of the Legal Aid, Sentencing and Punishment of Offenders Act 2012 (LASPO), legal aid has been withdrawn for most clinical negligence claims. A radically reformed system for conditional fee agreements (CFAs) became the primary source of funding for clinical negligence claims. But the NHS Litigation Authority (NHSLA) reports high levels of claims that the NHS struggles to bear. Resources are limited and money spent defending claims is money that cannot be spent on healthcare. Are we in the midst of a compensation culture? Are doctors becoming increasingly defensive? The civil litigation system struggles to balance justice to patients and affordability to the NHS.
The Thalidomide tragedy was one of a series of disasters that well illustrates the dangerous nature of drugs. The Consumer Protection Act 1987 imposed on all producers of goods strict liability for unsafe products. But claiming under the Act is far from straightforward. Alternatives, such as negligence, offer little by way of advantage. We illustrate the difficulties through a range of case examples including vaccines and contaminated blood.
All health professionals confront ethical dilemmas. Chapter 3 asks how society understands and implements concepts of the sanctity of human life. Beauchamp and Childress’s ‘Four Principles’: autonomy, beneficence, non-maleficence and justice provide a framework for ethical conduct. Each is examined before we consider the role of religion and secularisation and difficult questions about respect for human life at the beginning and end of life.
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.
This chapter explores legal questions surrounding organ and tissue transplantation. We consider the Human Tissue Act 2004 which regulates transplantation in England and Northern Ireland, setting out and analysing the law in relation to both live donation and cadaver transplantation. We examine responses to the shortage of donated organs and consider the significant change to the law in Wales relating to cadaver transplantation in the Human Transplantation (Wales) Act 2013.
The Practice of Medicine Today examines the tiers of medical regulation. The first half of the chapter focuses on professional regulation undertaken by statutory regulators such as the General Medical Council (GMC), which sets standards for students and doctors, sets out guidance on how to meet them, operates a system of revalidation by which all licensed doctors must regularly demonstrate that they are fit to practise and disciplines doctors who fail to meet those standards. The second part examines the NHS and considers the role of a range of governance bodies from Monitor to the Care Quality Commission.
A Relationship of Trust and Confidence: Doctors must be able to keep secrets but the obligation is not absolute. This chapter examines the nature of the duty of confidentiality and explores the circumstances in which disclosure to others is justified or required. Considering landmark cases such as W v Egdell and Campbell v MGN and guidance from the General Medical Council, we chart the development of the legal claims for breach of confidence and the implications of a developing right to privacy, ‘misuse of private information’. In the latter part of the chapter, we consider the difficult issue of genetic privacy and the complex provisions of the Data Protection Act.