bluuebunny/crossref_metadata_2025 huggingface dataset:
Public Health Powers in Relation to Infectious Tuberculosis in England and France: A Comparison of Approaches
Authors: Da Lomba Sylvie , Martin Robyn
Published: October 2011

This article examines the legal responses to infectious tuberculosis in England and France. Given that tuberculosis has re-emerged as a public health threat in both countries, the differing jurisprudence and legal frameworks of disease control in the two jurisdictions warrant examination. Two questions arise in that respect: firstly, what is the role of the State in the protection of public health in the context of tuberculosis, and secondly, to what extent can the law intervene to coerce individuals to undertake health measures for the protection of society at large. These issues reveal the tensions that exist between the individual and public interest. France and England differ greatly in their responses to such tensions. Paradoxically, France, that has traditionally embraced strong State intervention, has been reluctant to curtail individual freedoms for the benefit of public health. Conversely, England, that has tended to be more closely associated with liberalism, has been ready to accept and even promote restrictions to individual freedoms in the collective interest.
Wrongful Life: The Problem of Causation
Authors: Mason J K
Published: October 2011

The paper considers the status of the wrongful life action particularly in the light of the recent acceptance of such actions in continental Europe. It is considered that the hurdle of causation is still not adequately overcome in these cases and, in a search for an answer to the difficulty, the author re-examines the Canadian case of Cherry v Borsman. This case was originally thought of as one of wrongful life associated with a negligently performed abortion and the paper attempts to overcome the problems of causation by comparing and contrasting the roles of the genetic counsellor and the abortionist. While the attempt is by no means wholly successful, it also serves to draw attention to some significant differences between wrongful life actions based on physical and mental disability in the neonate.
Pre-Implantation Genetic Diagnosis, Tissue Typing and Beyond: The Legal Implications of the Hashmi Case
Authors: Mulvenna Beverley
Published: October 2011

The legality of pre-implantation genetic diagnosis (PGD) has recently been confirmed by the Court of Appeal in the Hashmi case, based on a purposive construction of the statute. The court went on to declare tissue typing lawful and strained the wording of the statute in order to do so.

The Hashmi case confirms that it would be lawful for the HFEA to license tissue typing in the absence of PGD. However, the HFEA only licenses tissue typing where PGD is also indicated, on the basis of a blanket application of the welfare of the child test set out in S 13 (5). This policy can be criticised. Firstly, a blanket approach to S 13 (5) is not appropriate. Secondly, the HFEA is applying the test too strictly when compared to the ‘best interests’ test which would govern the situation were an existing child to be a potential donor. Thirdly, by licensing tissue typing in the Hashmi case, where it was the primary reason for testing, the HFEA has undermined the argument that it can be justified only in cases where it is ancillary to PGD. These arguments, coupled with human rights arguments, based on Art 8 and Art 12, could be used to challenge the legitimacy of the HFEA's policy.

The restriction on tissue typing to cases where PGD is also indicated is not ethically justified. It offers the same direct benefit to the embryo as PGD, namely selection for implantation. PGD does not cure the relevant condition so offers no additional benefit in a causative sense. Moreover, the Kantian injunction against treating people solely as means is not breached where the child will be wanted for its own sake, as well as for its potential as a cord blood donor.
Medical Law and Health Care Reform in Tanzania
Authors: Harrington John A.
Published: October 2011

This paper examines the manner in which the tensions created by health care reforms in Tanzania were manifested in problems of law and professional regulation. The extensive privatisation of health provision and the introduction of user fees in the public sector rested upon a commodification of health care which was itself only possible through the deployment of contract models. Tort litigation was recommended as a channel of accountability but only resulted in a further skewing of resources towards the wealthy. The stresses created by the advertising of medical services and by doctors’ abandonment of altruistic goals were reflected in the disciplinary case load of the Medical Council in Tanzania. Professional ethics and privileges adopted during the colonial period were unable to withstand the pressures of the market. The paper attempts to locate these processes within the context of global liberalisation of health care services, whether through Structural Adjustment Programmes (SAPS), or the General Agreement on Trade in Services (GATS). As such the Tanzanian experience can illustrate some of the possible legal and regulatory consequences of the current restructuring of health care provision in Britain.
Teaching Changes Attitudes to Genetic Testing for Aggressive Behaviour
Authors: Elger Bernice S. , Harding Timothy W.
Published: October 2011

A recent study points to the influence of a particular genotype on aggressive behaviour. In its report on “Genetics and human behaviour” (2002), the Nuffield Council on Bioethics (NCR) published recommendations concerning the possible impact of behavioural genetics on the legal system. We used a standardised anonymous questionnaire before and after one semester of teaching in order to test the influence of multidisciplinary teaching about criminology, including discussion of the NCR, on attitudes of law and psychology students towards genetic testing and the use of these tests by the criminal system. After teaching, attitudes of students were significantly more critical toward the use of these tests than before teaching. Teaching about behavioural genetics to students from other faculties and the general population should be encouraged.
Excessive Risk Disclosure: The Effects of the Law on Medical Practice
Authors: Heywood Rob
Published: October 2011

This article examines the debate surrounding the challenging concept of informed consent. It argues whilst the English courts have effectively excluded the use of the tort of battery as an appropriate mechanism for protecting a patient's right to self-determination, they have left the law in a state of flux due to the uncertainties associated with categorising similar claims within negligence where the onus is on risk disclosure. This confusion may stem firstly from the fact that medical practitioners are unsure exactly which risks to disclose, and secondly, from the way in which both doctors and patients perceive the consent process. The paper suggests this disorder may be having a detrimental effect on medical practice as medical practitioners are taking it upon themselves to disclose excessive information, which patient's may not want or need. A suggestion is also made that in these situations, in order that the law truly respects self-determination, consideration must be given to the patient's desire to waive their right to informed consent.

‘while all are agreed that “doctor knows best” is no longer acceptable, for some “doctor knows better” is just as outdated and paternalistic. The assumption that the doctor's knowledge is deployed to ends that are of benefit to patients is treated with suspicion.’ 1
Harmonizing the International Regulation of Embryonic Stem Cell Research: Possibilities, Promises and Potential Pitfalls
Authors: Campbell Angela , Nycum Gillian
Published: October 2011

Despite near unanimous global opposition to human reproductive cloning, the United Nations has been unable to reach a consensus as to how cloning practices should be regulated at the international level. As a result, the U.N. objective of establishing binding international regulations governing cloning and stem cell research has yet to be achieved. Given the lack of consensus that exists within the global community on this topic, it seems that any attempt to harmonize the international regulation of cloning and stem cell science will face important obstacles.

This paper seeks to illuminate the particular challenges to harmonizing international laws and policies related to stem cell research and human cloning, and to investigate potential methods for overcoming these challenges. By drawing on two other areas in which regulatory harmonization has been attempted, namely: environmental and human safety aspects of international trade, and pharmaceutical research and development, we study approaches to global regulatory harmonization. We conclude that while the challenges to harmonization are diverse and important, so too are the benefits of establishing uniformity in approaches to stem cell research worldwide. This paper proposes a model for harmonizing the regulation of stem cell research that focuses on broader norms and principles rather than specific rules. It further recommends that such harmonization should occur through a process initiated and developed by an independent international agency marked by diversity, both in terms of the cultural identities and perspectives represented, and the interdisciplinary expertise of its members.
The Compensation of the Victims of the Creutzfeldt-Jacob Disease in the United Kingdom
Authors: Boggio Andrea
Published: October 2011

Establishing no-fault compensatory schemes is problematic from both a political and legal point of view. In this essay, I analyse the process that led to the compensation of the victims of Creutzfeldt-Jacob Disease and its variant. The paper shows that, although the diseases present many similarities, the two processes took very different paths because of the different, political environments in which they took place. Moreover, several possible lessons can be drawn from the compensation of CJD victims, which can potentially affect the establishment of future no-fault schemes in the United Kingdom.
Public Health, Private Right: Constitution and Common Law
Authors: Brownsword Roger
Published: October 2011

This article argues that, if we question the relationship between private law and public health, we are led to deeper questions about the balance between public interest and private right. At a time of rapid developments in the bio-sciences and when public health projects such as the UK Biobank are being initiated, it is suggested that there urgently needs to be a debate about a constitutional framework for the regulation of public health.
Stem Cell Patents and Social Controversy: A Speculative View from Canada
Authors: Caulfield Timothy
Published: October 2011

In Canada, no patents on embryonic stem cell lines have been granted, though it seems likely that they are technically patentable. Nevertheless, there are reasons to believe that embryonic still cell patents may engender social controversy. Embryonic stem cell research remains a morally contested topic. The granting of patents in the area will serve as another opportunity to engage the debate. In addition, for those who have concerns about the commercialization of research and the commodification of life, stem cell patents will serve as another example of an undesirable trend.
De-Regulating Assisted Reproduction: Some Reflections
Authors: McLean Sheila A.M.
Published: October 2011

It seems to be widely accepted in the United Kingdom that some form of regulation of assisted reproductive technologies is appropriate. Drawing on the position of the Warnock Committee, the 1990 Human Fertilisation and Embryology Act sought to control assisted reproduction and research using human embryos. However, a recent report from the House of Commons Select Committee on Science and Technology recommended a more libertarian approach to assisted reproduction, arguing that the legitimacy of the state's intervention needs to be justified rather than assumed. This article explores the extent to which it is now justified to control access to assisted reproduction and concludes that the regulatory mechanism currently in place is unnecessarily restrictive.
Priority-Setting and Public Law: Potential Realised or Unfulfilled?
Authors: Keith Syrett
Published: October 2011

Diane Longley's work draws attention to the potential of public law to articulate procedural standards which, by structuring decision-making on the allocation of scarce healthcare resources, can contribute to the legitimation of the process of priority-setting. This article assesses the importance of this judicial function in the light of recent developments in health policy and analyses the extent to which courts may be said to have performed it successfully. It focuses in particular upon the decision of the Supreme Court of Canada in Auton v British Columbia (Attorney General), but in so doing seeks to draw lessons and to identify issues which are pertinent elsewhere, notably to English law.
Which Beings Should Be Entitled to Human Rights?
Authors: Bernat Erwin
Published: October 2011

This essay argues that genetic engineering techniques such as interspecies cloning will anew raise the question of who deserves the status of being a subject of the law. When domestic constitutions and international treaties use the terms ‘everyone,’ ‘no one,’ ‘person’ and ‘men and women’ they meant ‘ human beings’. Does the discussion to date on the status of the unborn provide guidance on the question of whether beings that do not belong to the species Homo sapiens could be included among those who earn the right to be recognised by law as persons? What are the characteristics that we see as being typically human? The author comes to the conclusion that the decisive characteristic is the capacity to act for normative reasons, including moral reasons and that the term moral agent or person in a legal sense should be given a definition that is ‘interspeciesistic’.
Constructing ‘Health’, Defining ‘Choice’: Legal and Policy Perspectives on the Post-PGD Embryo in Four Jurisdictions
Authors: Van Wagner Estair , Mykitiuk Roxanne , Nisker Jeff
Published: October 2011

Through Preimplantation Genetic Diagnosis, embryos created by IVF are selected for transfer to a woman based on particular characterisations, including the presence of genetic markers or a tissue match for a sibling. In this paper we examine the precise language used in the recent policy and regulatory documents of four jurisdictions (the United Kingdom, Australia, Canada and New Zealand) that in any way characterises the post-PGD embryo. We then explore the mutually constructed relationship between how that embryo is characterised and the purposes for which PGD is applied, as well as the types of uses to which the post-PGD embryo is ultimately relegated. As our analysis indicates, based on the information provided through PGD, a number of possible categorisations of the post-PGD embryo emerge depending both on the outcome of PGD, and the initial intention behind the procedure.
Mapping the Regulatory Framework for Human Genetic Databases in England and Wales
Authors: Kaye Jane , Gibbons Susan M C
Published: October 2011

The ‘regulatory space’ metaphor articulated by Rancher and Moran offers a useful framing device for mapping and understanding the complex dynamics and patterns of interaction between the actors who populate existing regulatory regimes. This paper applies the ‘regulatory space’ analytical approach to map out and, thereby, gain a deeper understanding of, the current governance of genetic databases and biobanks in England and Wales. The paper draws on legal research undertaken for an ongoing socio-legal project into genetic database governance. It demonstrates some benefits of using the regulatory space approach as a precursor to applying normative theories and principles to formulate specific recommendations for regulatory reform. It also identifies potential pitfalls. The findings and conclusions should assist in designing policy recommendations for regulating genetic databases and biobanks better in the future.
Tissue Samples as ‘Gifts’ for Research: A Qualitative Study of Families and Professionals
Authors: Dixon-Woods Mary , Cavers Debbie , Jackson Clare J , Young Bridget , Forster Joanne , Heney David , Pritchard-Jones Kathy
Published: October 2011

Current policy in many countries, including the UK, is that tissue samples used for medical research should be treated as ‘gifts’ from patients. This approach is increasingly criticised. Among the solutions proposed is introducing an individual property rights regime for tissue donors. We report a qualitative study of the views of 79 family members of children with cancer and 54 health professionals in the area of paediatric oncology. We argue that systems of governance and regulation need to respect the values of donors. A charitable trust model might be more consistent with the values of solidarity and reciprocity expressed by the study participants than an individual property rights approach.
Sex Selection under International Human Rights Law
Authors: Toebes Brigit
Published: October 2011

Sex selection embraces attempts to choose or influence the sex of a child before pregnancy, during pregnancy, and after birth (infanticide). This paper examines these issues from an international human rights perspective and considers whether human rights laws are permissive or prohibitive with regard to sex selection. It discusses some of the ethical views on the matter. India and the UK are used as case studies. In both countries sex selection is—roughly speaking—prohibited, but the difference is that, while in India there is widespread practice of ‘son preference’, in the UK reasons for choosing to sex select are mostly because of ‘family balancing’.

The key question is whether choosing the sex of one's child is inherent in the right of reproductive choice, which is an important principle under international human rights law. It will be concluded that international human rights law does not recognise a right to ‘sex selection’. Rather, international human rights law is generally geared towards prohibiting sex selection based on the assumption that it enhances discrimination of women. On this basis it is argued that a right to choose the sex of one's child is not an element of women's ‘right of reproductive choice’, which stipulates a right to choose the number and spacing of one's children, not the sex.

Based on these findings this article argues that international human rights law provides strong legal and moral grounds for prohibiting sex selection, in particular in countries like India where there is extensive practice of sex selection. In countries like the UK, where the current main reason to sex select is for ‘family balancing’, the basis for prohibition under international human rights law is not as strong, yet several reasons can be put forward to nonetheless prohibit the practice.
From Human Embryos to Interspecies Creations: Ethical and Legal Uncertainties Surrounding the Creation of Cytoplasmic Hybrids for Research
Authors: Ogbogu Ubaka , Caulfield Timothy , Shane Green
Published: October 2011

This article discusses the legal and policy implications of the creation of cytoplasmic hybrid embryos for stem cell derivation research in Canada. Drawing on recent debates in the United Kingdom over the legal and ethical propriety of this research technique, and consequent judicial reflection and legislative developments on the issue, the authors examine the legal status of this research in Canada, provide a critical analysis of arguments for and against conducting cytoplasmic hybrid research, and proffer recommendations for future Canadian policy action.
Older Minors and Circumcision: Questioning the Limits of Religious Actions
Authors: Fox Marie , Thomson Michael
Published: October 2011

On two occasions the Court of Appeal in England has addressed the legality of non-therapeutic circumcision performed on a minor unable to provide consent. Both cases involved disputes in post-separation families where one parent sought a male child's circumcision against the wishes of the other parent. In January 2008 the Supreme Court of Oregon was faced with a similar factual situation in the case of Boldt v Boldt. However, the boy at the centre of the dispute in Boldt was significantly older than in the English cases. The Supreme Court therefore concluded that the testimony of the boy himself, who is now 13, was required and remanded the case for a re-hearing in order that the trial court could specifically address his wishes with regard to circumcision. In this paper we offer a critique of the Oregon Court's somewhat elliptical reasoning in the Boldt case. We argue that cases involving male circumcision of older children raise important ethico-legal issues, which the Boldt judgements gloss over, and which English courts have yet to confront in the context of circumcision. Consequently, our aim in this paper is to use Boldt as a lens through which to explore and inform UK practice. We argue that this case fits into a characteristic pattern according to which judges, law makers and professional bodies shy away from confronting key ethico-legal questions raised by the tolerance in Anglo-American society of non-therapeutic genital cutting of male infants. In raising explicitly for the first time the position of older minors, the factual situation in Boldt affords us an opportunity to begin to address the limits of parents' rights to determine the future religious identity of their children. In seeking to analyse how Boldt and the questions to which it gives rise might inform UK law we focus on three issues. The first is the right of the boy at the centre of the dispute to determine which medical treatments or interventions to his body are permissible. The father's subsequent petitions for reconsideration and for certiorari mean that when the boy's testimony is finally heard by a court it is likely that he will be 14 or 15 years of age. We aim to assess how a UK court might respond if faced with the task of determining whether a minor could choose circumcision for himself in such a scenario. A subsidiary question here is the extent to which circumcision procedures are appropriately categorised as ‘medical treatment’. Finally we offer some more tentative thoughts on what limits may legitimately be placed on parental rights to make choices for their children when their choices are motivated by religious belief.
Law's Faith in Medicine
Authors: Harrington John
Published: October 2011

This paper uses techniques of rhetorical criticism to chart the rise and fall of law's faith in clinical medicine in the period from the foundation of the National Health Service in 1948. In the early decades of the NHS, courts elaborated a series of topics or commonplaces in justifying a generous liability regime for doctors and the concession of extensive clinical discretion. Since the 1980s these topics have declined in persuasiveness. Current medical law rhetoric draws from and contributes to the prevalent culture of consumerism and accountability.
The Legality of Tissue Transplants for the Benefit of Family Members in the UK and Australia: Implications for Saviour Siblings
Authors: Shih-Ning Then
Published: October 2011

The ethics of creating ‘saviour siblings’ for the benefit of another has received much attention, but little consideration has been given to the legal position of those saviours born who may be asked to provide tissue for transplantation to another during childhood. This article examines the ethical issues surrounding minor donation as well as the existing legal framework in the UK and Australia that regulates minors providing tissue for the benefit of another. Against this background the position of minor saviours, who are called upon to donate bone marrow or peripheral blood stem cells, is examined. This analysis suggests that the law does not provide sufficient protection for minor saviours who are called upon to donate to another. It is argued that specific ethical obligations are owed to saviours—that ought to be reflected in the law—in order to protect them from exploitation while they remain minors.
Broad Consent in Biobanking: Reflections on Seemingly Insurmountable Dilemmas
Authors: Caulfield Timothy , Kaye Jane
Published: October 2011

Biobanking has long generated a host of challenging ethical and legal issues, particularly in relation to consent. A topic at the heart of current debates is the acceptability of the use of ‘broad’ consent in place of more specific and conventional consent approaches. In this paper, the justifications for the move toward broad consent are analysed and critiqued. It is concluded that all of the justifications-such as concern for costs, the desire to do research in the public good and the concept of minimal risk—remain contentious and seem insufficient, at least on their own, to stand as a rationale for a move away from traditional notions of consent.
The Role of Privacy and Informed Consent in Danish and Swedish Biobank Practices: Exploring Donor Perspectives
Authors: Hoeyer Klaus
Published: October 2011

Medical research using genetic information and biobanks, like many other aspects of medical research, has been regulated predominantly on a presumption that informed consent is the most effective vehicle for protecting the individual rights and freedoms, including privacy, of the research participants. The English word and concept ‘privacy’ can be difficult to translate, and this paper explores what privacy might be seen as relating to in a Swedish and Danish context. It is argued that concerns about what in English is called ‘privacy’ in Sweden and Denmark also relate to conceptions of ‘home’ and includes not only a private right but social duties too. Partly as a consequence of different political and social responses to biobank regulation in the two countries, there are some differences in the number and type of studies available. The remainder of the paper considers the findings of some published studies, most of which focus on attitudes towards informed consent. It is argued that some of the differences between the two countries indicated by published studies might reflect different policy landscapes and not the attitudes of the respective publics.
Parental Involvement in End-of-Life Decisions in Neonatology: Legal Considerations with Regard to Dutch Medical Practice
Authors: Dorscheidt Jozef H.H.M. , Verhagen Eduard , Sauer Pieter J.J. , Hubben Joep H.
Published: October 2011

Developments in legal and medical research regarding end-of-life decisions regarding severely suffering neonates in the Netherlands provide good cause for reflection on specific items of this issue. This article deals with the outcomes of the first national survey on end-of-life practice in Dutch Neonatal Intensive Care Units (NICUs) and examines the legal aspects of parental involvement in the decision making process. In this regard the authors reflect on the Dutch interpretation of ‘hopeless and unbearable suffering’, the medical-professional conduct in case of medical neonaticide, parental authority over an infant's fundamental right to life and the role of parents in supervising legal-procedural aspects.
Consent, Autonomy and the Infantilised Patient
Authors: Robertshaw Paul , Thacker Rajeev
Published: October 2011

In this article we examine a particular aspect of the doctor-patient relationship — that of consent to treatment procedures — from three perspectives: ethics, sociology of medicine, and the Common Law. The legal deliberation and judgments are considered within the first two perspectives. Ethics provide us with ideal standards such as personal autonomy or the sanctity of life, whereas the sociological perspective focuses on the actuality of the doctor-patient relationship in terms of knowledge and mystification or power and dependence.

In our analysis of the cases, including a spate of recent decisions, we note how the rhetoric of patient autonomy in the leading House of Lords cases has not followed through into the later crisis-handling judgments. We argue that the practical model for these decisions is not the rhetoric of autonomy but the prerogative jurisdiction of wardship: the infantilised patient. We argue that there is an aspect of professional collusion here between lawyers and doctors, which exemplifies much of the sociological literature as well as the individual constituted as subject, rather than citizen, in English jurisprudence.

We suggest a number of reforms for the situation we have criticised.
Legal and Ethical Considerations of the Human Genome Project
Authors: McLean Sheila A.M. , Giesen Dieter
Published: October 2011

This article seeks to highlight some of the more important ethical and legal issues raised by the Human Genome Project. It is recognized that hithertofore ethical control over the pace and scope of scientific progress has been only partly successful, due largely to the resistance of the professionals involved to outside interference and to the ineffectiveness of self-monitoring. The Human Genome Project has the potential to alter the lives of individuals and the structure of human society as a whole. It is essential therefore that individuals be empowered through the application and development of existing heads of liability in constitutional and private law to effect at least some of the necessary control. The transnational aspects of the project and the ethical and legal issues which it raises are also stressed.
Bridging the Gap Between Planning and Markets: Regulating Public Hospitals in Britain and France
Authors: Griggs Steven , Radcliffe James
Published: October 2011

This article compares the impact of recent legislation on health care in Britain and France. It examines the contrasts between the British aim of introducing an internal market into health care with French efforts to improve planning systems. It is contended that there are serious problems with both reform proposals, but that aspects of the French planning reforms may provide potential solutions to the flaws in the NHS internal market.
The Doctors' Dilemma: Necessity and the Legality of Medical Intervention
Authors: Wilson William , Smith K.J.M.
Published: October 2011

The defence of necessity has traditionally been conceived as providing a utilitarian justification for what would otherwise be criminal conduct. In the medical field, however, the nature of the justificiation has hitherto been based upon a concern to respect patient rights. The developing defence of ‘patient's best interests’ must be fully articulated so as to ensure that this respect is maintained and thus ensure the continued confluence of public and patient interests.
Assisted Suicide for People with Depression: An Advocate's Perspective
Authors: Biggs Hazel , Diesfeld Kate
Published: October 2011

Assisted suicide is a topical issue which has been brought to public attention recently through international cases and legislation. In particular, a recent case in the Netherlands concerning the assisted suicide of a depressed patient, and the pro assisted suicide legislation in Oregon, raise disturbing issues especially for advocates representing people with mental or terminal illness.

The justifications for assisted suicide for both groups appear similar since both are vulnerable. Their vulnerability stems either from physical and emotional exhaustion caused by disease or mental distress and depression (J. Griffiths, 1994), which is often concomitant with physical disease (J. Billings, S. Block, 1994). Therefore, it is valuable to analyse the issues raised by assisted suicide for people with depression in either group.

The arguments for assisted suicide are manifold, but the way in which society responds highlights inherent assumptions regarding the quality of life of people with depression. The limited rights and protections for people with mental disabilities in Britain emphasise the necessity for ethical inquiry and advocacy on behalf of these individuals. However, a conflict may arise for the advocate who opposes the ultimate outcome, death, yet values legal representation of the stated desires of the client.
Statutory Regulation of the Professional Conduct of Pharmacists in Great Britain and the USA
Authors: Sturgess R. , Harrison I.
Published: October 2011

The concept and regulation of a code of ethics and professional conduct are approached differently in Great Britain and the USA. In Great Britain, the Royal Pharmaceutical Society has no definition of professional conduct, its Code of Ethics covering only those items upon which it believes that it must make a comment or explanation. Individual States in the USA have definitions of professional conduct, which are defined and regulated by the State legal system.
Abortion Laws: Comparative and Feminist Perspectives in Australia, England and the United States
Authors: Petersen Kerry
Published: October 2011

In this article I examine the paradoxical nature of abortion developments in three jurisdictions and find that reproductive freedom is a more elusive goal in the United States where abortion has been elevated to a qualified right, than in England or Victoria where nineteenth century criminal statutes have been modified but not repealed. Abortion is now a moral scapegoat in the United States and it is difficult to predict if it will ever be resolved. Changes to law in the other two jurisdictions were less extreme and were shaped by a gradual change in attitudes towards abortion. Nevertheless, the laws in all three jurisdictions deny women full reproductive freedom and are founded on the assumption that women are not responsible moral beings. The repeal of all laws concerning abortion would be a stepping stone to re-framing moral questions about abortion and developing a distinctive feminine morality which attends to the needs of women.
Disputes in the NHS Internal Market: Regulation and Relationships
Authors: McHale J.V. , Hughes D. , Griffiths L.
Published: October 2011

An important element in the NHS internal market, introduced by the national health Service and Community Care Act 1990, was the “NHS” contract — an agreement between purchasers and providers who were within the NHS but who were not in a direct management relationship to each other. The framers of the legislation intended that such contracts should be excluded from judicial enforcement and instead be subject to a special statutory dispute resolution procedure. This paper examines those factors which have impacted upon the resolution of NHS contractual disputes in practice drawing upon empirical research undertaken as part of an ERSC funded study.
Decisions and Responsibilities at the End of Life: Euthanasia and Clinically Assisted Death
Authors: Biggs Hazel
Published: October 2011

The advent of advanced medical technology and its ability to prolong living and dying has, together with greater patient autonomy, inspired increasing awareness of euthanasia and assisted death. Doctors confronted by distressed patients seeking treatments, which may be construed as euthanasia, can experience a profound moral dilemma that emanates from the conflict between their ethical duty to relieve suffering, and the responsibilities imposed upon them by the law. Respect for individual autonomy is central to modem medical practice; but the absolute endorsement of the patient’s right to autonomy at the end of life may compromise the clinician’s professional and ethical integrity. This paper details the uneasy equilibrium between the rights of patients and the responsibilities of doctors at the end of life.
Protection of Medical Confidentiality without a Medical Privilege? — A Discussion of the English and the German Approach
Authors: Michalowski Sabine
Published: October 2011

The article illustrates the operation of the concept of medical confidentiality in the course of criminal court proceedings which are used to highlight the conflicting interests in full disclosure of all relevant information, including confidential patient information, and in the protection of patient confidences. The principles of protection of confidential patient information in England will be contrasted with the legal situation in Germany, where medical privilege extends to the court room and is embodied in the Criminal Procedure Code. It is submitted that the interests of justice are not necessarily undermined by the concept of medical privilege and that medical confidentiality can only be comprehensively protected if protection extends to the court room.
Adolescents and Mental Disorder: Who Consents to Treatment?
Authors: Bridge Caroline
Published: October 2011

Although English law recognises that developing adolescents may acquire the capacity to make decisions about medical treatment themselves it does not address the problem of mentally disturbed or disordered adolescents. This article examines the nature of adolescent refusal of treatment and suggests that a line be drawn between three categories of adolescent disturbance—the competent young person who refuses treatment that an adult too may refuse, the rebellious teenager whose refusal is triggered by simple teenage angst, and the mentally ill teenager whose refusal is triggered by mental illness. It suggests that adolescent autonomy needs to be more fully understood and the Mental Health Act more readily used in treating young people.
The Views of Semen Donors regarding the Swedish Insemination Act 1984
Authors: Daniels K.R , Ericsson H.L. , Burn I.P.
Published: October 2011

The Swedish Insemination Act (1984) provides for offspring who were conceived by donor insemination (DI) the right to have access to the identity of the donor when they have reached maturity. This paper reports on the attitudes and views of donors in a Swedish clinic in relation to the Act. It looks at the debate that occurred at the time of the introduction of the Act and the arguments both for and against the maintenance of traditional donor anonymity. It looks at the effect the Act has had on the numbers and types of men donating and considers the implications of the actions taken by some infertile couples to prevent their child from finding out the identity of the relevant donor. It also looks at the issues which the Swedish welfare services will need particularly to consider as the time approaches when the first of the DI offspring conceived under this legislation come to ‘maturity’, and start requesting access to information about donors. The attitudes of donors in this study are then compared with those of donors in other countries. Finally, the legislative approach taken in Sweden is compared with the more educative approach undertaken in New Zealand to the issue.
Generic Consistency in the Reproductive Enterprise: Ethical and Legal Implications for Exclusion Testing for Huntington's Disease
Authors: Beyleveld Deryck , Quarrell Oliver , Toddington Stuart
Published: October 2011

This paper applies Alan Gewirth's Principle of Generic Consistency (PGC) to assess the morality of exclusion testing for Huntington's Disease (HD).

Part 1 presents the PGC and outlines ways in which its use may be justified.

Part 2 considers how the PGC might grant protection to potential agents as such (the moral status of which is problematic under the PGC).

Part 3 contends that the morality of exclusion testing rests not only on its implications for the fetus (at most a potential agent), but also on the intended relations between the possibly affected parent and the future “child-when-agent” (CA) (born after a negative test) that are intrinsic consequences of the central motivation for exclusion testing.

Part 4 argues that the PGC renders it immoral, all things being equal, to permit exclusion tests on the fetus unless CA is granted (under specified circumstances) a right to find out whether the at risk parent is carrying the mutation for HD, with the implication that it is morally wrong for the at risk parent to be provided with the results of an exclusion test unless a legally binding duty is imposed on him or her to undergo a mutation test at CA's request. This right and its correlative duty might, however, be overridden by conflicting rights-considerations. The complexities of such an assessment are indicated.
Patients’ Rights and Doctors’ Responsibilities: Confluence and Conflict
Authors: Jessop David S.
Published: October 2011

The Lord Chancellor has recently announced that he is considering implementing a Law Commission Report which recommends that advance directives, or living wills, made by patients should be given statutory force. This would codify the common law principle that a patient has an absolute right to refuse treatment, regardless of whether the treatment was necessary to save their life. An advance directive would also enable a patient to stipulate in advance that their treatment be terminated should they later succumb to a persistent vegetative state (PVS). Advance directives can serve as important subjective evidence of where the patient's best interests lie, and obviate many of the present legal and moral difficulties inherent in a situation where the best interests of a PVS patient must be determined by a doctor. However, little attention has been paid to the category of advance directive in which a patient insists on treatment which the medical profession regards as futile or disproportionately expensive. In the light of evidence that such insistence directives already have legal validity, we may anticipate an inevitable clash with issues of public policy and finite economic resources for healthcare.
Informing Potential Participants of Local Research Ethics Committee Approval of Research Protocols
Authors: Beyleveld Deryck , Longley Diane
Published: October 2011

An increasing number of protocols submitted to LRECs contain a statement, on the information sheets for potential participants, to the effect that the research has obtained ethical approval. Whilst it may be considered desirable to inform potential participants that the proposed research has been subjected to independent scrutiny and obtained approval there has been some debate about what patients might infer from the inclusion of a such a statement. This is of particular concern if they are encouraged to believe that the research is safe and are thus influenced, in an unacceptable manner, to agree to take part. This paper reports on the results of research which sought to ascertain the possible effects of statements of LREC approval on potential participants in clinical trials, and the views of LRECs on the issue.
The French Parliamentary Guidelines of May 1997: Clarification or Fudge?
Authors: Latham Melanie
Published: October 2011

In July 1994 three bioethics laws were passed in France which attempted to resolve the moral and legal dilemmas arising from the New Reproductive Technologies (NRTs). A particularly troubling issue for French legislators was the status of the human embryo and its ensuing rights. Was the human embryo a person or a thing? Article 8 of law 94-654 on donation and assisted conception left this unclear, particularly in relation to embryo research. Unfortunately, regulatory decrees published in May 1997 on embryo research and prenatal diagnosis constitute an unsuccessful attempt at further clarification of the issue. Lawyers, clinicians and embryo rights activists alike may justifiably denounce them as a mere fudge.
Fertility Clinics: One Code of Practice?
Authors: Savas Diane , Treece Stephen
Published: October 2011

Since the enactment of the Human Fertility and Embryology Act 1990, Fertility Clinics have been obliged to work within the HFEA guidelines to comply with the requirements of their licences. However the recent media focus on certain aspects of assisted conception calls into question the degree of subjective interpretation that is applied by individual clinics with regard to the guidelines. This paper is the result of an empirical study examining how clinics interpret the guidelines, and will examine the question of whether the existing guidelines should be tightened to remove some of the inherent ambiguities.
The Living Will: Does an Advance Refusal of Treatment Made with Capacity Always Survive any Supervening Incapacity?
Authors: Bernat Erwin
Published: October 2011

There is a widespread consensus in law and medical ethics that living wills have to be obeyed by the physician if the patient was competent when the medical directive was signed and if, after the patient becomes incompetent, additional conditions occur which were considered by him. According to this viewpoint, the effectiveness of living wills is a direct consequence of the patient's right of self-determination. As the British Law Commission has recently put it: “An advance refusal made with capacity simply survives any supervening incapacity.” However, this opinion does not take into account the empirical fact that the formerly competent person's critical interests (at t1) do not necessarily correspond with his experiential interests after incompetency is established irreversibly (at t2). The author's goal is to answer the question of whether there can be cases which do not allow the formerly competent person's critical interests to prevail over the incompetent patient's experiential interests.
Self-sensing and quality factor control circuits for piezoelectric millimeter-sized resonant cantilevers
Authors: Zihajehzadeh Sh. , Maroufi M. , Shamshirsaz M. , Rezaie A. H.
Published: October 2011

For ever-increasing applications of resonant piezoelectric-excited millimeter-sized cantilever (PEMC) such as biosensors, viscosity, and density sensors, the need for design and implementation of a portable circuit for measuring the resonant frequency shift and/or the variation in the quality factor of PEMC becomes crucial. In this article, active and passive self-sensing bridge circuits are designed, fabricated, and implemented for a PEMC. The performances of these circuits are examined for the resonant frequency and quality factor measurements for vibration of PEMC in two different environments. For this purpose, a parameter-tuning procedure for the passive bridge based on experimental identification of Van Dyke model parameters is proposed and applied for the vibration of PEMC in air and 98% glycerol solution. Also, a compensation method for potential instability of active bridge circuit is proposed and developed experimentally for the vibration of PEMC in these environments. To increase the quality factor, the fabricated passive bridge is used in a designed control circuit, which is based on positive feedback signal proportional to the vibration velocity. The experiments show that with the proposed and implemented control circuit, the quality factor will increase by about 80% in air and 25% in glycerol.
Electrically excited oscillation and crystalline structure of a nanoclay/poly(vinylidene fluoride) composite film
Authors: Murasawa Go , Nishioka Akihiro , Miyata Ken , Koda Tomonori , Cho Hideo
Published: October 2011

This study was conducted to investigate electrically excited oscillation and crystalline structure of nanoclay/poly(vinylidene fluoride) (PVDF) composite films. First, nanoclay/PVDF composite films are fabricated by solvent casting. Second, their PVDF crystalline structure and nanoclay orientation are analyzed using x-ray diffraction. The impedance characteristics of films are then measured. Third, the oscillation excited from films as a result of applied voltage is measured. Thereby, we confirmed the presence of unoriented β-phase PVDF crystals and exfoliated-type nanoclay structure in a composite film. The output oscillation showed monotonic component corresponding to the input sinusoidal voltage at a high frequency range, although its amplitude is low.