19. Medical Assistance in Dying

This chapter discusses ethical and legal aspects of euthanasia and assisted dying. It first examines the non-voluntary termination of life, covering the relationship between medical treatment and assistance in dying as a matter of failure to treat, and the philosophical concept of ‘double effect’. The chapter then discusses activity and passivity in assisted dying; dying as an expression of patient autonomy; suicide and assisted suicide; physician-assisted suicide; and assisted dying in practice.

17. The Diagnosis of Death

This chapter begins with a discussion of concepts of death. It considers the mostly philosophical arguments against the use of the term ‘brain death’ as applied to the person and then explains the medico-legal effects of applying brainstem death criteria. The chapter also discusses post-mortem pregnancy.

15. The Body as Property

This chapter examines the question of the limits set on our right to control our bodies or parts thereof. This debate has centred on the very important issue of our relationship with our body, and the status of the body, which has most recently been shaped by ideas of property. The chapter considers three aspects of that debate: property in material taken from living persons; property in material taken from cadavers; and the granting of intellectual property rights in human material.

11. Civil and Criminal Liability in Reproductive Medicine

This chapter discusses: the nature of the duty of care in the action for wrongful pregnancy; legal action for wrongful birth; wrongful (or diminished) life actions; and wrongful injury to the fetus and feticide.

8. The Management of Infertility and Childlessness

This chapter discusses ethical and legal aspects of managing infertility and childlessness. It addresses the control of assisted reproduction in the UK; insemination; the infertile or childless woman; and surrogate motherhood.

6. Medical Confidentiality

This chapter discusses ethical and legal aspects of medical confidentiality. It covers the relationship between confidentiality and data protection law; the possible exceptions to the confidentiality rule; confidentiality and the legal process; confidentiality for the purposes of medical research; patient access to medical records; remedies for breach of confidentiality; and confidentiality and death.

13. Treatment of the Aged

This chapter discusses some of the ethical and legal issues associated with the very difficult practice of treating the elderly, grounding the discussion in the tension between autonomy and paternalism. It is emphasised that this complex and fragmented field is still undergoing significant regulatory changes as a result of the Care Act 2014, the Social Services and Well-being (Wales) Act 2014, and the Public Bodies (Joint Working) (Scotland) Act 2014. It also covers the elder incapax and dying from old age.

2. Public Health and the State–Patient Relationship

This chapter orients medical law in the broader context of public and community health, emphasising the human rights components of health promotion, health protection and the management of threats to the community through a variety of legal frames, as well as the role of physicians for good and ill.

12. Health Resources and Dilemmas in Treatment

This chapter discusses ethical and legal aspects of the global distribution of medical resources; the allocation of national resources; and medical treatment of the individual. It argues that so long as decisions are made taking into account fundamental moral values and principles of equity, impartiality, and fairness, and provided the bases for decision making are flexible in relation to the times, then the underlying system is just and is likely to yield just results.

5. Liability for Medical Injury

This chapter discusses ethical and legal aspects of medical liability. It covers compensation for injury; the basis of medical liability; what constitutes negligence; the problem of the novice; protecting patients from products; protecting patients from themselves; the doctrine of res ipsa loquitur; operational failures; causation; injuries caused by medical products or devices; and criminal negligence.