Biomedical Law and Ethics Library – serie

Posthumous reproduction refers to the procedure that enables a child to be conceived using the gametes of a dead person. Advances in reproductive technology mean it is now possible to assist in creating a life after you die, and in recent years the number of women who have attempted to get pregnant using posthumous reproduction has increased. However, the law in many jurisdictions has not put regulations in place to deal with the ethical and legal consequences that arise as a result of posthumous reproduction.This is the first book to exclusively focus on posthumous reproduction. The book comprehensively explores the legal and ethical issues surrounding posthumous reproduction in a number of jurisdictions including the US, Israel, the UK and France. The book looks at a number of issues including: ascertaining the wishes of the dead and protecting the reproductive rights of men who have deposited frozen sperm in clinics prior to their deaths; cases involving people who want to acquire fresh sperm from deceased or incompetent men and determining who should have the right to accept the sperm; identifying the parents of the posthumously conceived child; and discussing the need to promote the best interests of the child. The book critically examines the current laws that are in place and proposes additional regulations and policies in order to effectively regulate posthumous reproduction.

This book is a contribution to the nascent discourse on global health and biomedical research ethics involving Muslim populations and Islamic contexts. It presents a rich sociological account about the ways in which debates and questions involving Islam within the biomedical research context are negotiated - a perspective which is currently lacking within the broader bioethics literature. The book tackles some key understudied areas including: role of faith in moral deliberations within biomedical research ethics, the moral anxiety and frustration experienced by researchers when having to negotiate multiple moral sources and how the marginalisation of women, the prejudice and abuse faced by groups such as sex workers and those from the LGBT community are encountered and negotiated in such contexts. The volume provides a valuable resource for researchers and scholars in this area by providing a systematic review of ethical guidelines and a rich case-based account of the ethical issues emerging in biomedical research in contexts where Islam and the religious moral commitments of Muslims are pertinent.The book will be essential for those conducting research in low and middle income countries that have significant Muslim populations and for those in Muslim-minority settings. It will also appeal to researchers and scholars in religious studies, social sciences, philosophy, anthropology and theology, as well as the fields of biomedical ethics, Islamic ethics and global health..

The high profile cases of Charlie Gard, Alfie Evans, and Tafida Raqeeb raised the questions as to why the state intrudes into the exercise of parental responsibility concerning the medical treatment of children and why parents may not be permitted to decide what is in the best interests of their child. This book answers these questions. It argues for a reframing of the law concerned with the medical treatment of children to one which better protects the welfare of the individual child, within the context of family relationships recognising the duties which professionals have to care for the child and that the welfare of children is a matter of public interest, protected through the intervention of the state.This book undertakes a rigorous critical analysis of the case law concerned with the provision of medical treatment to children since the first reported cases over forty years ago. It argues that understanding of the cases only as disputes over the best interests of the child, and judicial resolution thereof, fails to recognise professional duties and public responsibilities for the welfare and protection of children that exist alongside parental responsibilities and which justify public, or state, intervention into family life and parental decision-making. Whilst the principles and approach of the court established in the early cases endure, the nature and balance of these responsibilities to children in their care need to be understood in the changing social, legal, and political context in which they are exercised and enforced by the court. The book will be a valuable resource for academics, students, and practitioners of Medical Law, Healthcare Law, Family Law, Social Work, Medicine, Nursing, and Bioethics.

This volume explores different models of regulating the use of restrictive practices in health care and disability settings. The authors examine the legislation, policies, inspection, enforcement and accreditation of the use of practices such as physical, mechanical and chemical restraint. They also explore the importance of factors such as organisational culture and staff training to the effective implementation of regulatory regimes. In doing so, the collection provides a solid evidence base for both the development and implementation of effective approaches to restrictive practices that focus on their reduction and, ultimately, their elimination across health care sectors. Divided into five parts, the volume covers new ground in multiple respects. First, it addresses the use of restrictive practices across mental health, disability and aged care settings, creating opportunities for new insights and interdisciplinary conversations across traditionally siloed sectors. Second, it includes contributions from research academics, clinicians, regulators and mental health consumers, offering a rich and comprehensive picture of existing regulatory regimes and options for designing and implementing regulatory approaches that address the failings of current systems. Finally, it incorporates comparative perspectives from Australia, New Zealand, the Netherlands, Germany and England.The book is an invaluable resource for regulators, policymakers, lawyers, clinicians, consumer advocates and academics grappling with the use and regulation of restrictive practices in mental health, disability and aged care contexts.

This volume explores different models of regulating the use of restrictive practices in health care and disability settings. The authors examine the legislation, policies, inspection, enforcement and accreditation of the use of practices such as physical, mechanical and chemical restraint. They also explore the importance of factors such as organisational culture and staff training to the effective implementation of regulatory regimes. In doing so, the collection provides a solid evidence base for both the development and implementation of effective approaches to restrictive practices that focus on their reduction and, ultimately, their elimination across health care sectors. Divided into five parts, the volume covers new ground in multiple respects. First, it addresses the use of restrictive practices across mental health, disability and aged care settings, creating opportunities for new insights and interdisciplinary conversations across traditionally siloed sectors. Second, it includes contributions from research academics, clinicians, regulators and mental health consumers, offering a rich and comprehensive picture of existing regulatory regimes and options for designing and implementing regulatory approaches that address the failings of current systems. Finally, it incorporates comparative perspectives from Australia, New Zealand, the Netherlands, Germany and England.The book is an invaluable resource for regulators, policymakers, lawyers, clinicians, consumer advocates and academics grappling with the use and regulation of restrictive practices in mental health, disability and aged care contexts.

The globalisation of research has resulted in the increased location of research involving humans in developing countries. Countries in Africa, along with China and India, have seen research grow significantly. With emerging infectious diseases, such as Ebola and Zika, emphasising the risk of public health crises throughout the world, a further increase in health research, including clinical research in developing countries, which are often the sites of these diseases, becomes inevitable. This growth raises questions about domestic regulation and the governance of health research. This book presents a comprehensive and systemic view of the regulation of research involving humans in African countries. It employs case studies from four countries in which research activities continue to rise, and which have taken steps to regulate health research activity: South Africa, Nigeria, Kenya, and Egypt. The book examines the historical and political contexts of these governance efforts. It describes the research context, some of the research taking place, and the current challenges. It also looks at the governance mechanisms, ranging from domestic ethical guidelines to legal frameworks, the strengthening of existing regulatory agencies to the role of professional regulatory bodies. The book analyses the adequacy of current governance arrangements within African countries, and puts forward recommendations to improve the emerging governance systems for health research in African and other developing countries. It book will be a valuable resource for academics, researchers, practitioners and policy-makers working in the areas of health research, biomedical ethics, health law and regulation in developing countries.

Is it lawful for a doctor to give a patient life-shortening pain relief? Can treatment be lawfully provided to a child under 16 on the basis of her consent alone? Is it lawful to remove food and water provided by tube to a patient in a vegetative state? Is a woman’s refusal of a caesarean section recommended for the benefit of the fetus legally decisive? These questions were central to the four focal cases revisited in this book.This book revisits nine landmark cases. For each, a new leading judgment is attributed to an imagined judge, Athena, who operates within the constraints of the legal system of England and Wales. Her judgments accord with an innovative legal theory, referred to as ‘modified law as integrity’, and are linked as a line of precedent. The result is a re-spinning of extant judicial threads into a web of legal principles with a greater claim to coherence and defensibility than those in the original cases.The book will be of great interest to scholars and students of medical law, criminal law, bioethics, legal theory and moral philosophy.

This book is a contribution to the nascent discourse on global health and biomedical research ethics involving Muslim populations and Islamic contexts. It presents a rich sociological account about the ways in which debates and questions involving Islam within the biomedical research context are negotiated - a perspective which is currently lacking within the broader bioethics literature. The book tackles some key understudied areas including: role of faith in moral deliberations within biomedical research ethics, the moral anxiety and frustration experienced by researchers when having to negotiate multiple moral sources and how the marginalisation of women, the prejudice and abuse faced by groups such as sex workers and those from the LGBT community are encountered and negotiated in such contexts. The volume provides a valuable resource for researchers and scholars in this area by providing a systematic review of ethical guidelines and a rich case-based account of the ethical issues emerging in biomedical research in contexts where Islam and the religious moral commitments of Muslims are pertinent.The book will be essential for those conducting research in low and middle income countries that have significant Muslim populations and for those in Muslim-minority settings. It will also appeal to researchers and scholars in religious studies, social sciences, philosophy, anthropology and theology, as well as the fields of biomedical ethics, Islamic ethics and global health..

The high profile cases of Charlie Gard, Alfie Evans, and Tafida Raqeeb raised the questions as to why the state intrudes into the exercise of parental responsibility concerning the medical treatment of children and why parents may not be permitted to decide what is in the best interests of their child. This book answers these questions. It argues for a reframing of the law concerned with the medical treatment of children to one which better protects the welfare of the individual child, within the context of family relationships recognising the duties which professionals have to care for the child and that the welfare of children is a matter of public interest, protected through the intervention of the state.This book undertakes a rigorous critical analysis of the case law concerned with the provision of medical treatment to children since the first reported cases over forty years ago. It argues that understanding of the cases only as disputes over the best interests of the child, and judicial resolution thereof, fails to recognise professional duties and public responsibilities for the welfare and protection of children that exist alongside parental responsibilities and which justify public, or state, intervention into family life and parental decision-making. Whilst the principles and approach of the court established in the early cases endure, the nature and balance of these responsibilities to children in their care need to be understood in the changing social, legal, and political context in which they are exercised and enforced by the court. The book will be a valuable resource for academics, students, and practitioners of Medical Law, Healthcare Law, Family Law, Social Work, Medicine, Nursing, and Bioethics.

Is the legal protection that is given to the expression of Abrahamic religious belief adequate or appropriate in the context of English medical law? This is the central question that is explored in this book, which develops a framework to support judges in the resolution of contentious cases that involve dissension between religious belief and medical law, developed from Alan Gewirth’s Principle of Generic Consistency (PGC).This framework is applied to a number of medical law case studies: the principle of double effect, ritual male circumcision, female genital mutilation, Jehovah’s Witnesses (adults and children) who refuse blood transfusions, and conscientious objection of healthcare professionals to abortion. The book also examines the legal and religious contexts in which these contentious cases are arbitrated. It demonstrates how human rights law and the proposed framework can provide a gauge to measure competing rights and apply legitimate limits to the expression of religious belief, where appropriate. The book concludes with a stance of principled pragmatism, which finds that some aspects of current legal protections in English medical law require amendment.

Healthcare Ethics, Law and Professionalism: Essays on the Works of Alastair V. Campbell features 15 original essays on bioethics, and healthcare ethics specifically. The volume is in honour of Professor Alastair V. Campbell, who was the founding editor of the internationally renowned Journal of Medical Ethics, and the founding director of three internationally leading centres in bioethics, in Otago, New Zealand, Bristol, UK, and Singapore. Campbell was trained in theology and philosophy and throughout his career worked with colleagues from various disciplines, including law and various branches of healthcare. The diversity of topics and depth of contributors’ insights reflect the breadth and impact of Campbell’s philosophical work and policy contributions to healthcare ethics. Throughout his long academic career, Campbell’s emphasis on healthcare ethics being practice-oriented, yet driven by critical reflection, has shaped the field in vital ways. The chapters are authored by leading scholars in healthcare ethics and law. Directly engaging with Campbell’s work and influence, the essays discuss essential questions in healthcare ethics relating to its methodology and teaching, its intersection with law and policy, medical professionalism, religion, and its translation in different cultural settings. Chapters also grapple with specific enduring topics, such as the doctor-patient relationship, justice in health and biomedical research, and treatment of the human body and the dead.

Due to new developments in prenatal testing and therapy the fetus is increasingly visible, examinable and treatable in prenatal care. Accordingly, physicians tend to perceive the fetus as a patient and understand themselves as having certain professional duties towards it. However, it is far from clear what it means to speak of a patient in this connection.This volume explores the usefulness and limitations of the concept of ‘fetal patient’ against the background of the recent seminal developments in prenatal or fetal medicine. It does so from an interdisciplinary and international perspective. Featuring internationally recognized experts in the field, the book discusses the normative implications of the concept of ‘fetal patient’ from a philosophical-theoretical as well as from a legal perspective. This includes its implications for the autonomy of the pregnant woman as well as its consequences for physician-patient-interactions in prenatal medicine.

Since the therapeutic value of umbilical cord blood (UCB) stem cells was first recognised in the late 1980s, there has been a proliferation of both public and private UCB banks worldwide. However, the ability to utilise such a potentially valuable resource has provoked a number of controversies. In a distinctly accessible style, this book unpacks the socio-legal implications of the UCB collection process and constructs a detailed analysis of the law and ethics that surrounds UCB banking in the UK, including ownership of the cells. Its enquiry is located within the theoretical framework of altruism versus self-interest and explores the notions of risk and choice associated with this distinctive blend of public/private healthcare provision. The book evaluates the impact of the Human Tissue Act 2004 and the European Union Tissues and Cells Directive (2004/23/EC) on the UCB industry and provides a unique insight into the effect that the law may have on the NHS whose maternity staff and premises are used to collect UCB. This book would be of interest primarily to a UK readership in addition to expectant families, health professionals, students, academics, practitioners and the UCB industry elsewhere in the world.

This book celebrates Professor Margaret Brazier’s outstanding contribution to the field of healthcare law and bioethics. It examines key aspects developed in Professor Brazier’s agenda-setting body of work, with contributions being provided by leading experts in the field from the UK, Australia, the US and continental Europe. They examine a range of current and future challenges for healthcare law and bioethics, representing state-of-the-art scholarship in the field.The book is organised into five parts. Part I discusses key principles and themes in healthcare law and bioethics. Part II examines the dynamics of the patient–doctor relationship, in particular the role of patients. Part III explores legal and ethical issues relating to the human body. Part IV discusses the regulation of reproduction, and Part V examines the relationship between the criminal law and the healthcare process.Chapter 10 of this book is freely available as a downloadable Open Access PDF under a Creative Commons Attribution-Non Commercial-No Derivatives 3.0 license. https://s3-us-west-2.amazonaws.com/tandfbis/rt-files/docs/Open+Access+Chapters/9781138861091_oachapter10.pdf

Locating assisted suicide within the broader medical end-of-life context and drawing on the empirical data available from the increasing number of permissive jurisdictions, this book provides a novel examination of the human rights implications of the prohibition on assisted suicide in England and Wales and beyond. Assisted suicide is a contentious topic and one which has been the subject of judicial and academic debate internationally. The central objective of the book is to approach the question of the ban’s compatibility with the European Convention on Human Rights afresh; freed from the constraints of the existing case law and its erroneous approach to the legal issues and selective reliance on empirical data. The book also examines the compatibility of the ban on assisted suicide with rights which have either been erroneously disregarded or not considered by either the domestic courts or the European Court of Human Rights. Having regard to human rights jurisprudence more broadly, including in the context of abortion, the research and analysis undertaken here demonstrates that the ban on assisted suicide violates the rights of a significant number of individuals to life, to freedom from torture or inhuman or degrading treatment and to private life. Such analysis does not depend on a strained or contrived approach to the rights at issue. Rather, the conclusions flow naturally from a coherent, logical application of the established principles governing those rights. While the focus of the book is the Suicide Act 1961, the conclusions reached have implications beyond England and Wales, including for the other devolved jurisdictions and international jurisdictions. Beyond courts and legislators, it will be a valuable resource for students of human rights and medical law, as well as medical and legal practitioners and academics working in human rights and end-of-life care.

Locating assisted suicide within the broader medical end-of-life context and drawing on the empirical data available from the increasing number of permissive jurisdictions, this book provides a novel examination of the human rights implications of the prohibition on assisted suicide in England and Wales and beyond. Assisted suicide is a contentious topic and one which has been the subject of judicial and academic debate internationally. The central objective of the book is to approach the question of the ban’s compatibility with the European Convention on Human Rights afresh; freed from the constraints of the existing case law and its erroneous approach to the legal issues and selective reliance on empirical data. The book also examines the compatibility of the ban on assisted suicide with rights which have either been erroneously disregarded or not considered by either the domestic courts or the European Court of Human Rights. Having regard to human rights jurisprudence more broadly, including in the context of abortion, the research and analysis undertaken here demonstrates that the ban on assisted suicide violates the rights of a significant number of individuals to life, to freedom from torture or inhuman or degrading treatment and to private life. Such analysis does not depend on a strained or contrived approach to the rights at issue. Rather, the conclusions flow naturally from a coherent, logical application of the established principles governing those rights. While the focus of the book is the Suicide Act 1961, the conclusions reached have implications beyond England and Wales, including for the other devolved jurisdictions and international jurisdictions. Beyond courts and legislators, it will be a valuable resource for students of human rights and medical law, as well as medical and legal practitioners and academics working in human rights and end-of-life care.

Whilst activities like transplantation and medical research have typically been considered on a discrete basis, they are also actually part of a broader phenomenon of medical means being employed to make use of human beings. This book is the first ever systematic critique of such medical use of the human being as a whole. It is divided into two parts. The first part considers what constitutes an appropriate normative lens through which to view such medical use and its constraint. It makes a reasoned ethical and human-rights-based case for preferring respect for human worth over any of the main alternative approaches that have been drawn on in specific contexts and outlines what this preference practically implies. The second part uses this respect-based lens to critique use discourse, law and practice. Drawing on three contrasting case study areas of warfare-related medical use, transplantation and human tissue research, this book exposes both the context-specific and thematic nature of shortfalls in respect.Overall this book provides a compelling analysis of how medical use ought to be constrained and a compelling critique of the excesses of discourse, practice and governance. It is recommended to academics, students, policymakers and professionals whose work is focused on or intersects with the medical sector and anyone else with an interest in medicine and its limits.

Analyzing the concepts of intention and causation in euthanasia, this timely new book explores a broad selection of disciplines, including criminal and medical law, medical ethics, philosophy and social policy and suggests an alternative solution to the one currently used by the courts, based on grading different categories of killing into a formalized justificatory defence.This text explores how culpability, blameworthiness and liability are ascribed and how ascertaining mens rea and actus reus are problematic in an end-of-life decision-making scenario. Williams criticizes the way the courts rely so exclusively on the criminal concepts of intention and causation in such medical scenarios and examines and raises awareness of the inadequate and inappropriate legal framework within in which judges have to operate. Topical and compelling, this significant contribution argues for a more open and honest approach which would, in turn, provide the certainty, consistency and equality required by the law.This is a quintessential read for all students studying medical and healthcare law and the legal aspects of health and medicine.

Technology has come to dominate the modern experience of pregnancy and childbirth, but instead of empowering pregnant women, technology has been used to identify the foetus as a second patient characterised as a distinct entity with its own needs and interests. Often, foetal and the woman’s interests will be aligned, though in legal and medical discourses the two ‘patients’ are frequently framed as antagonists with conflicting interests. This book focuses upon the permissibility of encroachment on the pregnant woman’s autonomy in the interests of the foetus. Drawing on the law in England & Wales, the United States of America and Germany, Samantha Halliday focuses on the tension between a pregnant woman’s autonomy and medical actions taken to protect the foetus, addressing circumstances in which courts have declared medical treatment lawful in the face of the pregnant woman’s refusal of consent.As a work which calls into question the understanding of autonomy in prenatal medical care, this book will be of great use and interest to students, researchers and practitioners in medical law, comparative law, bioethics, and human rights.

Written by a leading proponent of the philosophy and ethics of healthcare, this volume is filled with thought-provoking and frequently controversial ideas and arguments. Accessibly written, it provides readers with a timely contribution to the current literature on medical ethics, in which the concept of subjectivity is a key issue characterizing current medical humanities.Examining the critical assumption that scientifically-demonstrable facts will remove all uncertainty, the author argues that ethical dimensions of clinical practice do not always arise from undisputed facts, but that they are sometimes to be found at the level of the determinations of the facts themselves.Firmly placing the patient back on centre stage, without underestimating the crucial role which science plays in modern medicine, this volume is an excellent account of ethics and science in healthcare and their proper place in assessing and meeting people’s health needs.

Written by a leading proponent of the philosophy and ethics of healthcare, this volume is filled with thought-provoking and frequently controversial ideas and arguments. Accessibly written, it provides readers with a timely contribution to the current literature on medical ethics, in which the concept of subjectivity is a key issue characterizing current medical humanities.Examining the critical assumption that scientifically-demonstrable facts will remove all uncertainty, the author argues that ethical dimensions of clinical practice do not always arise from undisputed facts, but that they are sometimes to be found at the level of the determinations of the facts themselves.Firmly placing the patient back on centre stage, without underestimating the crucial role which science plays in modern medicine, this volume is an excellent account of ethics and science in healthcare and their proper place in assessing and meeting people’s health needs.

Analyzing the level of claims for clinical negligence in the light of the most recent trends and discovering whether there is indeed a litigation crisis in healthcare, this book is a topical and compelling exploration of healthcare and doctor-patient relationships.The author: identifies and analyzes the growing pressures on doctors in modern society, placing their role in contextexplores some of the myths surrounding media claims about malpracticeconsiders the practice of ‘defensive medicine’ and the difference between defensive practices and sensible risk managementexamines external pressures, such as political interference with clinical practice in the form of target-setting and what might be described as a culture of creeping privatization of healthcare. Covering the topics of medicine and the media and the causes of occupational stress among doctors, this volume is a must read for all students of medical law and medical ethics.

Analyzing the level of claims for clinical negligence in the light of the most recent trends and discovering whether there is indeed a litigation crisis in healthcare, this book is a topical and compelling exploration of healthcare and doctor-patient relationships.The author: identifies and analyzes the growing pressures on doctors in modern society, placing their role in contextexplores some of the myths surrounding media claims about malpracticeconsiders the practice of ‘defensive medicine’ and the difference between defensive practices and sensible risk managementexamines external pressures, such as political interference with clinical practice in the form of target-setting and what might be described as a culture of creeping privatization of healthcare. Covering the topics of medicine and the media and the causes of occupational stress among doctors, this volume is a must read for all students of medical law and medical ethics.

The book explores and explains the relationship between law and ethics in the context of medically related research in order to provide a practical guide to understanding for members of research ethics committees (RECs), professionals involved with medical research and those with an academic interest in the subject. Healthcare Research Ethics and Law sets out the law as it relates to the functions of Research Ethics Committees (RECs) within the context of the process of ethical review and aims to be accessible and readily understood by REC members. Each chapter begins by locating the material within the practical context of ethical review and then provides a more theoretical and analytical discussion detailing how the theory and practice fit together. The key legal issues of confidentiality, consent and negligence are addressed in detail, alongside practical guidance as to how and when liability may be incurred in these areas. In addition, the practical and legal implications of the implementation of European Directive 2001/20/EC, the Human Tissue Act 2004 and the Mental Capacity Act 2005 are considered alongside a discussion of their socio-political background and relevance for medical research in the UK.

Autonomy is often said to be the dominant ethical principle in modern bioethics, and it is also important in law. Respect for autonomy is said to underpin the law of consent, which is theoretically designed to protect the right of patients to make decisions based on their own values and for their own reasons. The notion that consent underpins beneficent and lawful medical intervention is deeply rooted in the jurisprudence of countries throughout the world. However, Autonomy, Consent and the Law challenges the relationship between consent rules and autonomy, arguing that the very nature of the legal process inhibits its ability to respect autonomy, specifically in cases where patients argue that their ability to act autonomously has been reduced or denied as a result of the withholding of information which they would have wanted to receive. Sheila McLean further argues that the bioethical debate about the true nature of autonomy – while rich and challenging – has had little if any impact on the law. Using the alleged distinction between the individualistic and the relational models of autonomy as a template, the author proposes that, while it might be assumed that the version ostensibly preferred by law – roughly equivalent to the individualistic model – would be transparently and consistently applied, in fact courts have vacillated between the two to achieve policy-based objectives. This is highlighted by examination of four specific areas of the law which most readily lend themselves to consideration of the application of the autonomy principle: namely refusal of life-sustaining treatment and assisted dying, maternal/foetal issues, genetics and transplantation.This book will be of great interest to scholars of medical law and bioethics.

Autonomy is often said to be the dominant ethical principle in modern bioethics, and it is also important in law. Respect for autonomy is said to underpin the law of consent, which is theoretically designed to protect the right of patients to make decisions based on their own values and for their own reasons. The notion that consent underpins beneficent and lawful medical intervention is deeply rooted in the jurisprudence of countries throughout the world. However, Autonomy, Consent and the Law challenges the relationship between consent rules and autonomy, arguing that the very nature of the legal process inhibits its ability to respect autonomy, specifically in cases where patients argue that their ability to act autonomously has been reduced or denied as a result of the withholding of information which they would have wanted to receive. Sheila McLean further argues that the bioethical debate about the true nature of autonomy – while rich and challenging – has had little if any impact on the law. Using the alleged distinction between the individualistic and the relational models of autonomy as a template, the author proposes that, while it might be assumed that the version ostensibly preferred by law – roughly equivalent to the individualistic model – would be transparently and consistently applied, in fact courts have vacillated between the two to achieve policy-based objectives. This is highlighted by examination of four specific areas of the law which most readily lend themselves to consideration of the application of the autonomy principle: namely refusal of life-sustaining treatment and assisted dying, maternal/foetal issues, genetics and transplantation.This book will be of great interest to scholars of medical law and bioethics.

A conflict arises in the clinic over the care of a critically ill, incapacitated patient. The clinicians and the patient’s family confront a difficult choice: to treat or not to treat? Decisions to withdraw or withhold life-sustaining treatment feature frequently in the courts and in the world's media, with prominent examples including the cases of Charlotte Wyatt, in the UK, and Terri Schiavo, in the USA. According to legislation like the Mental Capacity Act 2005, the central issues are the welfare (or ‘best interests’) of the patient, alongside any wishes they might have conveyed, via an ‘advance directive’ or through the appointment of a ‘lasting power of attorney’. Richard Huxtable argues that the law governing both welfare and wishes frequently fails to furnish clinicians and families with the guidance they require. However, he finds this unsurprising, given the competing ethical issues at stake. Huxtable proposes that there is a case for ‘principled compromise’ here, such that the processes for resolving principled disputes take precedence. He argues for greater ethical engagement, through a reinvigorated system of clinical ethics support, in which committees work alongside the courts to resolve the conflicts that can arise at the limits of life. Providing a comprehensive account of the law pertaining to children and adults alike, and distinctively combining medico-legal and bioethical insights, this book engages scholars and students from both disciplines, as well as informing clinicians about the scope (and limits) of law at the limits of life.

A conflict arises in the clinic over the care of a critically ill, incapacitated patient. The clinicians and the patient’s family confront a difficult choice: to treat or not to treat? Decisions to withdraw or withhold life-sustaining treatment feature frequently in the courts and in the world's media, with prominent examples including the cases of Charlotte Wyatt, in the UK, and Terri Schiavo, in the USA. According to legislation like the Mental Capacity Act 2005, the central issues are the welfare (or ‘best interests’) of the patient, alongside any wishes they might have conveyed, via an ‘advance directive’ or through the appointment of a ‘lasting power of attorney’. Richard Huxtable argues that the law governing both welfare and wishes frequently fails to furnish clinicians and families with the guidance they require. However, he finds this unsurprising, given the competing ethical issues at stake. Huxtable proposes that there is a case for ‘principled compromise’ here, such that the processes for resolving principled disputes take precedence. He argues for greater ethical engagement, through a reinvigorated system of clinical ethics support, in which committees work alongside the courts to resolve the conflicts that can arise at the limits of life. Providing a comprehensive account of the law pertaining to children and adults alike, and distinctively combining medico-legal and bioethical insights, this book engages scholars and students from both disciplines, as well as informing clinicians about the scope (and limits) of law at the limits of life.

Advances in genetic technology will lead to novel legal challenges. This book identifies four potential genomic claims which may be articulated as novel negligence challenges. Each of these claims is considered from the perspective of the English courts’ approach to novel kinds of damage. It is argued that these novel genomic claims are unlikely to be favourably received given the current judicial attitude to new forms of damage. However, Victoria Chico argues that the genomic claims could be conceived of as harm because they concern interferences with autonomy. Each claim is considered from the perspective of a hypothetical English negligence system imbued with explicit recognition of the interest in autonomy. Chico examines how recognition of this new form of damage would lead to novel genomic negligence claims being treated in a way which they would not, if considered within traditional parameters of harm in negligence.