Legal and Ethical Aspects of Healthcare

COVER......Page 1
HALF-TITLE......Page 3
TITLE......Page 5
COPYRIGHT......Page 6
CONTENTS......Page 7
ACKNOWLEDGEMENTS......Page 9
DEDICATION......Page 10
PREFACE......Page 11
A NOTE ON ABBREVIATIONS......Page 15
1 ABOUT MEDICINE AND THE LAW......Page 17
LEGAL INTERVENTION IN MEDICINE......Page 18
Divisions of the legal system......Page 20
The General Medical Council......Page 22
Controlling bodies for other healthcare professions......Page 23
Statutory control of the healthcaring professions......Page 24
THE DOCTOR AND THE NATIONAL HEALTH SERVICE......Page 25
THE LEGAL SYSTEM IN PRACTICE......Page 27
The courts in practice......Page 28
CASES REFERRED TO IN THE TEXT......Page 29
FURTHER READING......Page 30
2 RESOURCES – WHO DECIDES?......Page 31
DUTIES OF THE SECRETARY OF STATE......Page 32
An American experiment......Page 35
GOVERNANCE......Page 36
AT THE COAL-FACE: THE PATIENT AND THE DOCTOR......Page 39
CONCLUSION......Page 41
FURTHER READING......Page 42
CONFIDENTIALITY AND THE LAW......Page 45
CONFIDENTIALITY AND THE HEALTHCARE PROFESSIONS......Page 48
The patient consents......Page 49
Sharing information within the healthcare team......Page 50
CONFIDENTIALITY AND THE CHILD......Page 51
CONFIDENTIALITY WITHIN THE FAMILY......Page 53
Disclosure to the police......Page 54
MEDICAL CONFIDENTIALITY AND THE LEGAL PROCESS......Page 55
The public interest......Page 56
THE PATIENT’S RIGHTS......Page 58
CASES MENTIONED IN THE TEXT......Page 59
FURTHER READING......Page 60
THE COMPETENT ADULT PATIENT......Page 61
Arguments against full disclosure......Page 62
Arguments in favour of disclosure......Page 63
PATIENT AUTONOMY, ETHICS AND THE LAW......Page 64
How much information should have been disclosed?......Page 65
What test is to be applied?......Page 66
Proving harm......Page 67
England and Wales......Page 68
THE INCOMPETENT ADULT......Page 69
CASES REFERRED TO IN THE TEXT......Page 71
FURTHER READING......Page 72
5 REFUSAL OF CONSENT......Page 73
REFUSAL BASED ON PRINCIPLE......Page 74
REFUSAL ON PERSONAL GROUNDS......Page 75
REFUSAL IN THE COURSE OF PREGNANCY......Page 76
Hunger strikes......Page 78
Anorexia nervosa......Page 79
CHILDREN AND REFUSAL OF TREATMENT......Page 80
England and Wales......Page 81
ADVANCE DIRECTIVES......Page 82
CASES REFERRED TO IN THE TEXT......Page 84
FURTHER READING......Page 85
THE COMPLAINTS PROCEDURE......Page 87
LITIGATION......Page 88
Breach of duty......Page 89
Causation......Page 92
POLICY CONSIDERATIONS......Page 93
WHO WILL BE SUED?......Page 94
Vaccine damage......Page 95
Liability for defective products......Page 96
FURTHER READING......Page 98
7 USING PEOPLE FOR RESEARCH......Page 101
THE DECLARATION OF HELSINKI......Page 102
Consent......Page 103
Research and the legally incompetent......Page 104
THE NATURE OF RESEARCH......Page 105
Therapeutic research......Page 106
THE DESIGN OF RESEARCH......Page 107
WHO CONTROLS RESEARCH?......Page 108
WHAT HAPPENS IF HARM RESULTS FROM RESEARCH?......Page 109
GENETIC SCREENING AND TESTING......Page 110
GENE THERAPY......Page 112
FURTHER READING......Page 113
8 ASSISTED REPRODUCTION......Page 115
Causes of infertility in the woman......Page 116
Treatments for abnormalities in the male......Page 117
Treatments for abnormalities in the female......Page 118
THE HUMAN FERTILISATION AND EMBRYOLOGY ACT 1990......Page 119
Artificial insemination by husband or partner......Page 121
The clinic......Page 123
The would-be parents......Page 124
Ovum donation......Page 125
Embryo donation......Page 126
The Code of Practice......Page 127
The status of the embryo......Page 128
SURROGATE MOTHERHOOD......Page 129
CASES REFERRED TO IN THE TEXT......Page 132
FURTHER READING......Page 133
9 GENETICS AND PREGNANCY......Page 135
GENETICS AND REPRODUCTIVE CHOICES......Page 136
DESIGNER BABIES?......Page 137
INTERGENERATIONAL JUSTICE......Page 140
The child......Page 141
The parents......Page 142
INTERVENTIONS BEFORE BIRTH......Page 144
CONCLUSION......Page 145
FURTHER READING......Page 146
10 TERMINATION OF PREGNANCY......Page 147
FOETAL INTERESTS......Page 148
WOMEN’S RIGHTS......Page 150
Scotland......Page 152
THE ABORTION ACT 1967......Page 153
A legal duty to terminate pregnancy?......Page 155
Reduction of multiple pregnancy......Page 156
The conscientiously objecting professional......Page 157
PREGNANCY IN CHILDREN AND THOSE WHO ARE INCOMPETENT......Page 158
THE FUTURE......Page 159
FURTHER READING......Page 160
11 GENETICS, INSURANCE AND EMPLOYMENT......Page 163
GENETICS AND INSURANCE......Page 164
How relevant is health-related information?......Page 165
Predictive and actuarial value of genetic information......Page 168
GENETICS AND EMPLOYMENT......Page 170
Discrimination......Page 171
A right not to know?......Page 172
Health, safety and employment......Page 173
FURTHER READING......Page 175
SELF-KILLING OR SUICIDE......Page 177
The persistent (or permanent) vegetative state (PVS)......Page 179
WITHHOLDING AND WITHDRAWING TREATMENT......Page 182
The concept of futility......Page 183
Do not resuscitate orders (DNRs)......Page 184
The severely ill neonate......Page 185
Withdrawal of ventilator support......Page 187
PATIENTS’ RIGHTS......Page 188
Assisting someone to die......Page 189
ACTIVE EUTHANASIA......Page 191
The Netherlands......Page 192
CASES REFERRED TO IN THE TEXT......Page 193
FURTHER READING......Page 194
LEGAL CONTROL OF THE BODY......Page 195
DISPOSAL OF ORGANS AND TISSUES FROM THE BODIES OF THE DEAD......Page 198
Moore v Regents of the University of California (1990)......Page 201
ORGAN REPLACEMENT THERAPY......Page 202
The legal constraints......Page 203
Ethical aspects......Page 205
CADAVERIC DONATION......Page 207
The rationale of brain-stem death......Page 208
Cadaveric donation and the law......Page 209
THE SHORTAGE OF ORGANS......Page 210
THE USE OF ANIMAL ORGANS......Page 212
CASES REFERRED TO IN THE TEXT......Page 213
FURTHER READING......Page 214
THE DIAGNOSIS OF SEX......Page 215
TRANSSEXUALISM......Page 217
Transsexual marriage......Page 218
Transsexualism and Europe......Page 220
Transsexualism and employment......Page 222
CASES REFERRED TO IN THE TEXT......Page 225
FURTHER READING......Page 226
15 MENTAL HEALTH AND MENTAL CAPACITY......Page 227
Definition of mental disorder......Page 229
The problem of the psychopath......Page 230
Premature release into the community......Page 232
TREATMENT OF THE MENTALLY DISORDERED......Page 233
CAPACITY......Page 235
Capacity in the adult......Page 236
STERILISATION OF THE INCAPACITATED......Page 237
CONCLUSION......Page 238
FURTHER READING......Page 239
ARRANGEMENTS FOR LIVING......Page 241
Money, money, money!......Page 244
LIVING WITH THE FAMILY......Page 246
‘I WANT TO BE ALONE’......Page 247
MEDICAL TREATMENT AND THE ELDERLY......Page 249
DISPOSAL OF THE DEAD......Page 250
Death certification......Page 251
Cremation......Page 252
FURTHER READING......Page 254
INDEX......Page 255