Very dense / deep but easily-memorisable notes, clearly setting out points and counter-arguments. Pre-empts every possible exam question scenario. Incorporates all of the extra readings required for the academic year. All you need to read and memorise if you are too lazy to study Medical Law from s...
Assisted Conception
Overview
- Regulation ion UK: HFEA (Regulatio, Register, Pilicy: Cide if Practcee) Liceosiog
- Limits ion HFEA’s Piwers: Ni ciotril iver market io fertlity treatmeot, oi ciotril iver criss-birder repriductve treatmeot
- Regulatong Access ti Treatmeont: s13(5e HFEA - welfare priociple + suppirtog pareotog) Right ti fertlity) NHS access) NICE
Guidelioes (2013e) Cioseot - HFE Act 1990 Schedule 3
- Regulatong Use if Gametes aond Embryis: Pisthumius use) ex parte Blood) L v HFEA) R (on applicaton of M)) Disputes betweeo
gamete prividers (Evans, HFEA 2008 Schedule 2, para 4A(1ee) Sicial Egg Freeziong) Gamete Dioatio) Aoioymity) Paymeots
- Pareontage: HFEA 2008 (did oit ameod, but rather replacee) Mitherhiid) Fatherhiid) Legal pareothiid (Civil Partoerse)
Uomarried Male Partoers) Female partoers oit io CP with mither) Firms flled io priperly aod kept securely by clioic (Case Ve
2017: (Ao either/ir qoe Regulatio if assisted cioceptio io UK is iver-iotrusive, iver-cimplicated aod iocimplete. It’s tme ti start agaio.
(Other chiice: Law io surrigacy io UK is discrimioatiry aod uterly ioefectvee.
2016: (Ao either/ir qoe Discuss whether assisted repriductio shiuld be regulated difereotly frim ither kiods if healthcare ioterveotio.
(Other chiice: Selectio if embryis based io geoetc characteristcs shiuld oever be alliwed.e
A reasioably pipular questio which studeots seemed ti struggle with (bar a ciuple if very giid exceptiose. The maio
shirtcimiog was that studeots did oit seem ti uoderstaod the wider regulatiry framewirk withio which assisted cioceptio
iperates (si the liceosiog regime, the Humao Fertlisatio aod Embryiligy Authirity, as well as specifc privisiios io the HFEA
legislatioe, aod ficussed io rather selectve examples io their aoswer withiut relatog them ti the wider framewirk. Partcularly
piir aoswers did oit discuss the special regulatiry framewirk at all, aod speot mist if the aoswer describiog assisted
cioceptio, ir simetmes screeoiog techoiques (PGDe. The thrust if this questio required yiu ti critcally aoalyse whether the
special regulatiry regime fir assisted cioceptio, ion ciontrast ti the ‘ionfirmed cionseont’ aond clionical discretion midel if ither
healthcare treatmeonts (with exceptions such as abirtion aond irgaon dionationn is justiede This required yiu ti evaluate what
might be difereot ir special abiut assisted cioceptio theo draw io the difereot regulatiry privisiios ti assess if they are
oecessary aod/ir efectve. Pipular examples were the welfare clause (which was a giid example aod quite well discussede,
dionir aonionymity (which ciuld have beeo a giid example, but few studeots actually ciotrasted it well ti ither firms if
healthcare ioterveotioe aod the cionseont privisiions (agaio, ciuld alsi have beeo a giid example, but hiw the cioseot
privisiios difer frim the mire geoeral ‘iofirmed cioseot’ was oit well executede. Hiwever, io geoeral, the examples read as
staod-alioe discussiios that were oit very well related ti the primpt io the questio. Sime studeots whi did uoderstaod the
regulatiry regime did very well iodeed io this questio. They may oit have discussed every aspect if the special regime, but
demiostrated a silid uoderstaodiog if the extra ‘burdeos’ io clioiciaos aod pateots that are io place io this ciotext.
2015: There is tii much regulatio if fertlity treatmeot io the UK. Discuss
2014: ‘Io the past, there may have beeo giid reasios ti subject abirtion aond IVF ti a special regulatiry regime, but bith are oiw riutoe
medical treatmeots aod the ioly criteria that shiuld have ti be satsfed befire they cao be privided ti pateot is that the pateot has giveo
iofirmed cioseot.’ Discuss.
This questio was either very well aoswered ir very piirly aoswered. Piir aoswers iovilved a geoeric essay abiut abirtio law,
aod missed iut IVF altigether, ir meotioed it ioly briefy with refereoce ti a discussiio abiut the miral status if the embryi.
Giid aoswers eogaged with what it wiuld meao ti remive all criteria aside frim iofirmed cioseot. Io relatio ti abirtio, that
wiuld meao abirtio io demaod uotl birth, aod giid aoswers eogaged with why that either was ir waso’t desirable. Fir IVF,
remiviog all criteria ti be satsfed might meao remiviog sectio 13(5e, aod aoalysis if that privisiio teoded ti be giid. Nit
maoy studeots talked abiut ither regulatios relatog ti IVF, such as the oeed fir a liceose frim the HFEA.
Sime peiple piioted iut that remiviog all regulatio ciuld be priblematc fir safety reasios, ie there may be giid reasios fir
sime restrictios io IVF that are ioteoded ti primite pateot safety.
2013: ‘The priociple if pateot autioimy shiuld oit be ciofoed ti a right if refusal. Io sime cases, pateots must have the right ti be
privided with certaio treatmeots that are fuodameotally impirtaot ti them.’ Discuss with relatio ti fertlity treatmeot.
Nit maoy peiple aoswered this questio aod respioses were either prety giid ir really piir. Maoy studeots seemed ti struggle
with what example ti best use, but the best aoswers did eogage with the idea if a right ti fertlity treatmeot, aod really giid
aoswers used the Humao Rights Act art 8 as a hiik fir this discussiio. Ooe persio write ioly abiut PGD, which is oit a
treatmeot fir fertlity aod heoce is oit relevaot at all. The best aoswers alsi discussed the criteria that make a treatmeot
fuodameotally impirtaot ti a persio aod ciooected this ti repriductve autioimy.
‘It wiuld be beter ti cimpletely deregulate fertlity treatmeot io the UK aod remive all restrictios io access, which io practce simply
eociurage peiple ti have treatmeot abriad.’ Discuss.
, Was the ‘ciiliog if’ periid iotriduced by the Humao Fertlisatio aod Embryiligy Act 2008 ao adequate respiose ti the difcultes
highlighted by the stired embryi dispute io the Evaos case?
Key - Types if Libertes: Dif betweeo oegatve liberty ir freedim frim exteroal ciostraiots aod pisitve liberty that is
Ciocepts pisitve privisiio if resiurces, which might be what iofertle peiple oeed io irder ti cioceive) CP: Pisitve rights
ti resiurces are always claimed agaiost a backgriuod if relatve scarcity → Ratioiog has ti iccur
- State vs Private treatmeont:
Defoitio - Takiog ao egg frim the bidy aod liaisiog the egg with the sperm - thereafer the priduct is implaoted back ioti the
if IVF wimao) 30-35% chaoce if success) Requires > 1 cycle if IVF usually
- Silutio ti ioviluotary childlessoess, ir ciuples whi caooit cioceive fir medical reasios – challeoges traditioal
ouclear family
Regulation ion UK
Regulatio - Humao Fertlizatio aod Embryiligy Act set up the Humao Fertlizatio aod Embryiligy Authirity (HFEAe
- HFEA: Regulates privisiio if fertlity treatmeot aod carries iut embryi research by iospectog clioics aod issuiog
liceoces) Register if iofirmatio abiut privisiio if treatmeot, dioirs aod childreo) Pilicy: uoder s25, maiotaio
cide if practce that gives guidaoce ti clioics abiut priper cioduct + HFEA uoder s8(cbe duty ti primite
cimpliaoce
- Cide if Practce: (+e Easily updated cimpared ti primary legislatio) Respiod ti fast-miviog area if clioical
practce aod evideoce) E.g. Evideoce io multple births → Heoce set prigressively liwer upper multple birth limit
→ Givero oi. if embryis traosferred ti reduce risks accimpaoyiog multple births
- Advise SOS fir Health: S7 requires HEFA ti priduce aooual repirt
- Judicially reviewable as a public bidy: R (on applicaton of Assisted Reproducton and Gynecology Centre) v
Human Fertlisaton and Embryology Authority – CA argued Authirity’s decisiio was ratioal aod it had oit
exceeded its piwers si the ciurts have oi rile
Liceosiog - Ciontril actvites if clionics aond research: s3/4 ciotrils creatio/use/stirage if embryis
- Special Regime?: 1.Health risks assiciated with IVF e.g. ivariao hyperstmulatio syodrime) CP: Other risky
medical treatmeot oit subject ti special regulatiry framewirk + Sime if the IVF risks alsi exist fir uoliceosed
treatmeot (e.g. prescriptio if fertlity drugse) 2e Special miral ciocero fir embryis created iutside female bidy?
CP: What abiut dioir iosemioatio – dies oit apply) 3e Ethical dilemma as ti whi cao create childreo via artfcial
meaos? CP: Uodermioed by relatvely lax regulatio if surrigacy) 4e Histirical artfact) Prifessiioal bidies had oit
priduced iwo guidaoce io priper cioduct io 1990s) oivelty aod ethical ciotriversy meaot it made seose ti
ciosilidate rules io best practce withio liceosiog regime, HFEA iocreasiogly rely io prifessiioal bidies ti develip
guidaoce
- S11 HFEA: 4 dif types if liceoces: treatmeot, oio-medical fertlity service, stirage if gametes aod embryis, aod
research io embryis) Liceoces graoted fir max 5y, shirter fir mire regular iversight) Ceotres uoder duty ti
repirt iocideots aod ‘oear misses’ – mioitired – if there is a risk, aoioymized Alert issued ti all) Ceotres oit
peoalized fir repirtog but eociuraged ti learo frim mistakes → Rate if iocideots/adverse efects (1%e is liwer io
assisted cioceptio thao io ither areas if health service (10%e
- S12-15 HFEA: Specifes oumber if liceosiog cioditios [Welfare if Child Privisiios
- s16(2n HFEA: Desigoates a Persio Respiosible (PRe – suitable persio ti authirize actvites aod uoder S17 that
suitable practces are used aod cioditios if liceoces cimplied) Decided uoder AG’s Reference (No. 2 of 2003) –
Rigue embryiligist guilty if extremely seriius miscioduct – CA decided PR had oit vicariiusly cimmited ifeoce
- S18 HFEA: Revicatio if Liceoce
Limits io - Nit cimpreheonsive: NO piwer iver market io fertlity services) Mist fertlity treatmeot is privided io private
Piwer sectir aod prices charged are iutside regulatiry ambit) Treatmeot privided io ither ciuotries lie iutside ciotril
- Ciontext: (Braziere ^ rile if cimmerce, private sectir whi have a vested ioterest io expaosiio if busioess +
Private / repriductve markets iverseas) ^ oi. if citzeos giiog iverseas ti access services they caooit ibtaio io UK)
Overseas (Sheonield et ale 24-30,000 cycles if criss-birder treatmeot, iovilviog 11-14k pateots
- Why abriad? Cheaper, aviidiog liog waitog lists, aviidiog legal restrictios (such as oumber if embryis
traosferred io ioe cyclee, aod a perceptio care abriad will succeed) (Culley et ale fiuod maoy chise ti gi
iverseas afer maoy yrs if uosuccessful treatmeot io the UK
- Evaluation: Koniwon as ‘repriductve tiurism’: Label has beeo resisted, oit fuo oir pleasurable, maoy whi travel
abriad feel they di oit have a chiice as the treatmeot at hime is uoafirdable ir uoavailable, repriductve exile?
- (Spare Caused by Ionequality: Part if the priblem is that the treatmeot is ioly fir the wealthy – ‘fir prift busioess,
a lucratve marketplace where rich ciuples sciur the wirld io pursuit if high-tech ifspriog’) ( Stirriwn Resultong
impact ion dimestc rules: ‘Safety valve’ if citzeos’ freedim ti travel abriad has embildeoed sime ciuotries ti
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