This revision booklet includes the following topics:
- Medical Ethics
- Resource Allocation
- Assisted Reproductive Technologies
- Consent and Capacity
- Medical Negligence
- Abortion
- Organ Donation
,Rights and Medical Law
There are a number of rights that must
be considered within medical law: Ethical and the Law
What’s the point of ethical t
• Privacy based rights- including self-
determination (right to make our - Provide useful tools to g
own decisions), bodily integrity the appropriate legal re
(criminal acts such as assault, sexual Why do we need to consider ethics?
and/or help us to think
assault demonstrated that you have You can not look at medical law
about that legal respon
a right to choose who touches you) without considering the ethics behind
- Prompt you to process i
and confidentiality (this involves decisions. In some cases it is necessary
to consider not only if a decision is responses and alert you
issues, for example should the possible pitfalls of t
information regarding disease that legal but also ethical. As Emily Jackson
noted it is necessary to point to some particular position
could be given to someone e.g. STI -
coherent reasoning or moral principles Offer a clear and structu
and other sexual partners)
• Right to life- does this include a that explain or justifies our decisions. thinking about cases, an
• Key case in this area of law- Gillick- formulation of argumen
positive right to treatment? (can
you demand a certain treatment in A teenager being prescribed support or challenges th
the NHS) and to assistance in dying? contraception without the parents response
• Right to dignity- Free from decision. On appeal it was decided - Alert you to inconsisten
degrading treatment that a child can have capacity if it is possible unconscious bi
• Reproductive autonomy, positive deemed that they are mature and own through processes
and negative rights- Do women sophisticated enough. helping to provide cons
have the right to have the choice of legal decision-making a
an abortion, can you use a doner therefore fairness.
sperm after they died etc.
, Ethical and the Law
The Issue of Conjoined Twins
• Successful separation- Rital and Ritag Gaboura- In this case the twins were conjoined at the head, however Ritag was supplying half of Rital’s Blood, keeping her alive
heart would have began to fail due to the strain. The parents of the twins wanted them to be separated. The twins were successfully separated and were able to lea
lives.
• Not separated- Abby and Brittany Hensel- These twins were not separated however are determined to live the normal active lives of 20 year olds. They have been go
they travel, and they have jobs.
• A complicated case: ‘Jodie’ and ‘Mary’ (Gracie and Rosie Attard)- twins both had their own vital organs however their spines were fused, however twin Jodie sustaine
twins were to be separated then Mary would have died within minutes. The parents were strongly religious and was opposed to separation. Ward LJ noted that the
because of the conflicts of moral and ethical values and there is a search for a legal principle within a pressured time frame. There were multiple legal and ethical iss
- Does the end justify the means?
- Personhood
- Child welfare
- Sanctity of life vs quality of life
- Disability discrimination
- Parental rights
- Acts/omissions
- ‘playing God’/Letting nature take its course
- Slippery slopes
- Body ownership
What did the court decide-
- In the high court- ‘Separation, like the withholding of food and hydration would be an omission not a positive action. The proposed operation and the court of Mary’s d
amount to the interruption or withdrawal of the supply of blood which Mary receives from Jodie. Separation was in Mary’s best interests; her life was not simply worth n
become hurtful. To prolong it would thus be to her disadvantage. Therefore the court could authorise separation surgery along the lines set out in Airedale NHS Trust V B
withdrawal of treatment is lawful where such withdrawal is in the patients best interests.
- In the Court of Appeal- The question was raised as to how the interest of each child would as they were both legal persons be balanced. It is impossible to fully honour
child; the court must accept the least detrimental alternative separation. Separation can only proceed if lawful. Typically, the active and intentional ending of a persons li
crime of murder, but here no crime is committed because doctors are here in position of impossible conflict so law must allow them to choose the lesser of two evils and
taken in self-defence or the legitimate defence of others.
- The ratio decidendi of the case as decided as Ward LJ- ‘Ending the life of one in order to preserve the life of another is permissible only where certain stringent conditio
is impossible to preserve the life of X without bringing about the death of Y, that Y by his or her very continued existence will inevitably bring bout the death of X within a
time and that X is capable of living an independent life by Y is incapable under any circumstances including all forms of medical intervention, of viable independent existe
, Ethical and the Law
Consequentialism (Utilitarianism)
The action which we are morally obliged to do is that which produces, overall, in the long
run, the most going. The approach that nothing but consequences matter. For utilitarianism,
The Main Ethical
the consequences which matter are the pleasure or pain that result from our actions. Theories
Principle of utility- acts are right to the extent that they tend to promote utility (pleasure or
happiness), thus one should always act to promote the greatest happiness of the greatest
Deontology (Kantianism)
number (the greatest happiness principle).
Responds to some of the problems identified w
Advantages: consequentialism and captures the institution
- Simple and intuitively compelling- Should provide a clear answer to every case we choose to do particular things matters. But
- Democractive- non one’s preferences/values count for ant more than anyone else’s
- How do we decide on the right rules and w
grounds these rules?
Disadvantages: - Rigidly following the rules sometimes seem
- Extraordinarily morally demanding result in our doing what appears to be the
- The utilitarian calculation is difficult thing
- Utilitarianism claims that we should always act so as to maximise the amount of utility - All deontological theories give us more th
in the world, but it doesn’t say anything about the distribution of that utility. rule that we ought to follow. Because of th
In the case of Jodie and Mary to conjoined twins it would be taking the approach that we will be times when one rule tells us to act
should salvage one life rather than lose both. The detriment to Mary is outweighed by the certain way, and a different rule tells us th
benefit to Jodie. However there are factors to consider: must not act in that way.
- To what extent do we take account of broader consequences (setting a new precedent
Closer to the way that courts dealt with
to allow doctors actively to end life) and Mary conjoined twins case. A duty w
- How far do we take account of consequences for the parents? not to harm Mary (duty of nonmaleficen
- How easy is it to judge the consequences? was owed to Jodie to provide her with c
- Are the interests of people with disabilities likely to be fairly counted in the utilitarian of beneficence). This illustrates the prob
calculus? deontological approach, duties owed to
- Are there some lines which should not be crossed, whatever the gain? and Jodie, how to balance each duty?
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