scholarly journals Children’s best interests and parents’ views: challenges from medical law

2021 ◽  
Vol 43 (1) ◽  
pp. 23-41
Author(s):  
Annie Sorbie
Keyword(s):  
2018 ◽  
Vol 45 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Charles Foster

Over the last quarter of a century, English medical law has taken an increasingly firm stand against medical paternalism. This is exemplified by cases such as Bolitho v City and Hackney Health Authority, Chester v Afshar, and Montgomery v Lanarkshire Health Board. In relation to decision-making on behalf of incapacitous adults, the actuating principle of the Mental Capacity Act 2005 is respect for patient autonomy. The only lawful acts in relation to an incapacitous person are acts which are in the best interests of that person. The 2005 Act requires a holistic assessment of best interests. Best interests are wider than ‘medical best interests’. The 2018 judgment of the Supreme Court in An NHS Trust v Y (which concerned the question of whether a court needed to authorise the withdrawal of life-sustaining clinically administered nutrition/hydration (CANH) from patients in prolonged disorders of consciousness (PDOC)) risks reviving medical paternalism. The judgment, in its uncritical endorsement of guidelines from various medical organisations, may lend inappropriate authority to medical judgments of best interests and silence or render impotent non-medical contributions to the debate about best interests—so frustrating the 2005 Act. To minimise these dangers, a system of meditation should be instituted whenever it is proposed to withdraw (at least) life-sustaining CANH from (at least) patients with PDOC, and there needs to be a guarantee of access to the courts for families, carers and others who wish to challenge medical conclusions about withdrawal. This would entail proper public funding for such challenges.


Author(s):  
Louise Austin ◽  
John Coggon

This chapter explores whether controlled non-heart-beating organ donation (NHBOD) can be in the best interests of an intensive care patient who has expressed a wish to become an organ donor. It begins with an acknowledgment of the concerns health professionals may have about NHBOD before providing an analysis of medical law in the context of decision making and best interests. It concludes that the law’s interpretation of best interests means there will be some situations where NHBOD will be in the best interests of patients in intensive care. It also considers the lack of legal certainty regarding the necessary observation time between the cessation of heart beat and the commencement of organ retrieval.


Author(s):  
Robert Gay

Virtue ethics is a way of viewing the moral life in terms of the necessary dispositions which shape human action towards the good, and towards human flourishing. Thinking of the moral life in terms of virtue was the dominant approach to moral philosophy in ancient and medieval thought. Although largely absent as a major strand of thought in moral philosophy after the Enlightenment, it has key features which challenge the dominant approaches in moral philosophy. The second half of the twentieth century saw a revival in virtue ethics, inspired by philosophers such as Anscombe and MacIntyre. The Hippocratic tradition provides a virtue framework for medicine, and the revival of virtue ethics has led to further work to explore the importance of virtue in medical practice. In the morally and technically complex world of medical practice, the virtues of prudence, justice, fortitude, and temperance are necessary for the doctor to act according to the best interests of the patient, which are in line with the proper ends of medicine. The law has a role in prohibiting acts which are not in accordance with the ends of medicine, which cannot be virtuous. It also has a role in helping to arrive at prudential decisions in cases where there are disputes between patients or their families and medical teams about a best course of action. Finally, medical law should have a role in cultivating virtue within medicine for the benefit of patients and doctors.


2020 ◽  
Vol 28 (4) ◽  
pp. 696-730
Author(s):  
Neera Bhatia ◽  
Giles Birchley

Abstract In this article, we examine emerging challenges to medical law arising from healthcare globalisation concerning disputes between parents and healthcare professionals in the care and treatment of critically ill children. We explore a series of issues emerging in English case law concerning children’s medical treatment that are signs of increasing globalisation. We argue that these interrelated issues present distinct challenges to healthcare economics, clinical practice, and the operation of the law. First, social media leverages the emotive aspects of cases; secondly, the Internet provides unfiltered information about novel treatments and access to crowdfunding to pay for them. Finally, the removal of barriers to global trade and travel allows child medical tourism to emerge as the nexus of these issues. These aspects of globalisation have implications for medicine and the law, yet child medical tourism has been little examined. We argue that it affects a range of interests, including children’s rights, parents’ rights as consumers, and the interests of society in communalised healthcare. Identifying putative solutions and a research agenda around these issues is important. While cases involving critically ill children are complex and emotionally fraught, the interconnectedness of these issues requires the law to engage and respond coherently to the impacts of healthcare globalisation.


2018 ◽  
Vol 26 (1) ◽  
pp. 16-37 ◽  
Author(s):  
Priscilla Alderson

Article 12 with its concern to give “due weight” to children’s views involves potential contradictions between human rights to self-determination and children’s rights. A set of conditions in Article 12 turns rights into highly qualified permissions that can transfer agency and control from children onto adults. These are further complicated by reports by the un Committee on the Rights of the Child and others that position children’s best interests against their expressed views, and by contrasting standards set by national laws and guidance. Theories about children’s rights in medical law differ from actual practice in reported cases, which are influenced by long-standing theories about childhood in philosophy and psychology that disregard realities in children’s lives. Barriers to due respect for children’s views in medical law and practice that need to be addressed are summarised.


2003 ◽  
Vol 29 (2-3) ◽  
pp. 269-299
Author(s):  
Janna C. Merrick

Main Street in Sarasota, Florida. A high-tech medical arts building rises from the east end, the county's historic three-story courthouse is two blocks to the west and sandwiched in between is the First Church of Christ, Scientist. A verse inscribed on the wall behind the pulpit of the church reads: “Divine Love Always Has Met and Always Will Meet Every Human Need.” This is the church where William and Christine Hermanson worshipped. It is just a few steps away from the courthouse where they were convicted of child abuse and third-degree murder for failing to provide conventional medical care for their seven-year-old daughter.This Article is about the intersection of “divine love” and “the best interests of the child.” It is about a pluralistic society where the dominant culture reveres medical science, but where a religious minority shuns and perhaps fears that same medical science. It is also about the struggle among different religious interests to define the legal rights of the citizenry.


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