{"title":"A different kind of death? Barts NHS Trust v Dance and Battersbee","authors":"B. Lyons, M. Donnelly","doi":"10.1177/09685332231159363","DOIUrl":"https://doi.org/10.1177/09685332231159363","url":null,"abstract":"The case of Archie Battersbee, a 12-year-old boy who suffered a catastrophic hypoxic brain injury, was the subject of several Family Division and Appeal Court hearings between April and August 2022. During the protracted legal process, appeals were made by the family to the Supreme Court, the European Court of Human Rights, and the United Nations’ Committee on the Rights of Persons with Disabilities (CRPD Committee). These were unsuccessful in achieving a stay on the withdrawal of life-sustaining interventions, whose continuance the Family Division of the High Court had found not to be in Archie’s best interests. This commentary focuses on two novel aspects of the proceedings: the Court of Appeal’s overturning of Arbuthnot J’s conclusion that Archie was brainstem dead, and the CRPD Committee’s intervention in response to the family’s appeal.","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"23 1","pages":"159 - 173"},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47985208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Beazley, Helen Dewson, Michael Butler, Simon Le Marquand
{"title":"Autism and the draft mental health bill in England and Wales: Unintended consequences?","authors":"P. Beazley, Helen Dewson, Michael Butler, Simon Le Marquand","doi":"10.1177/09685332231158740","DOIUrl":"https://doi.org/10.1177/09685332231158740","url":null,"abstract":"The Draft Mental Health Bill for England and Wales proposes a range of changes to the Mental Health Act 1983. Among these is a proposal to amend the definition of ‘Mental Disorder’, which would mean that people with a primary diagnosis of autism or learning disability would be excluded from most of the civil sections of the Act. If enacted, this will be the first occasion in English and Welsh law where a legal definition of autism is created. While we argue that there are inherent difficulties in creating legal definitions of clinical problems, this ‘legal Autism’ appears to be substantially disconnected from a clinical understanding of autism, and its breadth could potentially encompass conditions beyond those currently identified as autism. Moreover, numerous potential unwanted practical consequences may arise from these changes, partly because of uncertainty about the legal position of presentations that share features with autism, uncertainty about the process of assessment of ‘legal Autism’, and potential perverse incentives placed on local authorities. We argue that particular groups of people likely to be impacted by these changes are those who not only present with profound clinical impairments, but also who pose significant risks to others. We urge serious consideration is given to these issues in the legal debate of the Bill.","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"23 1","pages":"174 - 188"},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47809832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reference by the Attorney General for Northern Ireland – Abortion Services (Safe Access Zones) (Northern Ireland) Bill [2022]: The proportionality of safe access zone legislation","authors":"Emily Ottley","doi":"10.1177/09685332231164784","DOIUrl":"https://doi.org/10.1177/09685332231164784","url":null,"abstract":"In an unanimous judgment given by Lord Reed on 7 December 2022, the Supreme Court of the United Kingdom (UKSC) held that clause 5(2)(a) of the Abortion Services (Safe Access Zone) (Northern Ireland) Bill is a proportionate interference with the rights of those who wish to express opposition to abortion services in Northern Ireland. This clause would make it an offence to do an act within the safe access zone with the intention of or being reckless as to the possibility of directly or indirectly influencing a protected person. In this comment, I analyse the reasoning of the UKSC. I consider, first, the clarifications offered by the UKSC on issues related to the proportionality assessment itself. I then turn my attention to the application of the proportionality test by the UKSC to the facts of the reference. I conclude that the reasoning of the UKSC in Reference by the Attorney General for Northern Ireland – Abortion Services (Safe Access Zones) (Northern Ireland) Bill is sound. The UKSC’s decision is relevant to plans to introduce similar legislation in Scotland and to any future human rights based challenges to the English and Welsh Public Order Bill, which will create a similar offence to the one in clause 5(2)(a) of the Northern Ireland Bill when it becomes law later this year. Moreover, the decision is significant because the UKSC had not previously considered the proportionality of safe access zone legislation. The Abortion Services (Safe Access Zone) (Northern Ireland) Bill has now received Royal Assent.","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"23 1","pages":"88 - 98"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45302132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The EU legal framework on clinical trials directed to therapeutic germline gene alteration: A critical and systematic analysis","authors":"T. Faltus, Í. de Miguel Beriain","doi":"10.1177/09685332231154586","DOIUrl":"https://doi.org/10.1177/09685332231154586","url":null,"abstract":"Interventions in the human germline, whether for purposes of therapy for a hereditary disease or for purposes of enhancement, are controversial. While enhancement is almost unanimously rejected, therapy-oriented intervention is not a priori regarded as unacceptable. The legal discussion so far has focused primarily on the questions of whether manipulation of the embryo’s germline is permissible or whether the genetic manipulation of germ cells and the use of these germ cells for embryo generation is permissible. Up to now, the upstream questions regarding the systematic germline therapy development in clinical trials have been ignored, including questions as to whether the development of germline therapy would be legally permissible within the European Union framework of clinical studies. This article highlights the legal issues connected with the clinical development of germline intervention, provides an overview of the various answers to these legal questions, and indicates where further research and discussion are needed.","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"23 1","pages":"44 - 70"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42262459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Book review: Law at the Frontiers of Biomedicine","authors":"R. Brownsword","doi":"10.1177/09685332231167102","DOIUrl":"https://doi.org/10.1177/09685332231167102","url":null,"abstract":"1. S. Pattinson, Law at the Frontiers of Biomedicine (Oxford: Hart Publishing, 2023). 2. Seminally, A. Gewirth, Reason and Morality (Chicago, IL: University of Chicago Press, 1978). 3. Pattinson, Law at the Frontiers, pp. 40–41. 4. Seminally, D. Beyleveld, The Dialectical Necessity of Morality: An Analysis and Defense of Alan Gewirth’s Argument to the Principle of Generic Consistency (Chicago, IL: University of Chicago Press, 1991). Book review","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"23 1","pages":"99 - 106"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42487420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The end of (reproductive) liberty as we know it: A note on Dobbs V. Jackson Women’s Health 597 USC __ (2022)","authors":"E. C. Romanis","doi":"10.1177/09685332231154562","DOIUrl":"https://doi.org/10.1177/09685332231154562","url":null,"abstract":"In Dobbs v. Jackson Women’s Health, a 6–3 majority of the US Supreme Court overturned 50 years of established precedent, ruling that the Constitution confers no right to abortion. Since first recognition that the constitutional right to privacy encompassed a (negative) right to pre-viability abortion in 1973, Supreme Court decisions have slowly chipped away at the substance of this right. Dobbs, however, marks a significant shift in abortion (and general) jurisprudence, by deploying an originalist interpretation of the constitution to deny that such a right exists. Consequently, States may now regulate abortion how they see fit, including by introducing complete prohibitions. This note illustrates how Dobbs has dire consequences for reproductive freedom as we have known it, with disastrous legal and practical ramifications for abortion-seekers, pregnant people, and all people with the physiology to become pregnant. Furthermore, the Court’s use of an originalist approach to rescind a constitutional protection signals further moves to derecognise other rights such as contraception, as well as same-sex intimacy.","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"23 1","pages":"71 - 87"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46304988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rethinking the regulation of digital contraception under the medical devices regime","authors":"C. McMillan","doi":"10.1177/09685332231154581","DOIUrl":"https://doi.org/10.1177/09685332231154581","url":null,"abstract":"Contraceptives are vital healthcare for women and people with wombs. Recently, there has been a rise in the use of ‘digital contraceptives’, a type of ‘femtech’ software available for download on app stores which require data input in order to make predictions about users’ fertility. Digital contraceptives, when marketed as such, fall within the definition of a ‘medical device’ and under the authority of the Medical Devices Regulations 2002 are a ‘medium-risk’ device. However, not all femtech which may be used as contraception is captured by this framework. In this article it is argued that the regulatory category into which digital contraceptives have been placed by the medical devices regime is (a) unduly limited in scope, (b) insufficiently stringent to protect users, considering the grave and life-changing effects this technology can have if things go wrong, and (c) ill-conceived as a regulatory response to a technology that affects large sections of the population. It is suggested here that the broader context in which software as a contraceptive sits (i.e. within the general contraceptive market) is key to understanding the regulatory blindness that is occurring when it comes to digital contraceptives and some other forms of fertility-related femtech. As such, software which can be used as a contraceptive is in fact ‘high risk’ and should be reclassified as such.","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"23 1","pages":"3 - 25"},"PeriodicalIF":0.0,"publicationDate":"2023-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46152431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health data governance in China: Emphasizing ‘sharing’ and ‘protection’ based on the right to health","authors":"Lujian Sun","doi":"10.1177/09685332221140416","DOIUrl":"https://doi.org/10.1177/09685332221140416","url":null,"abstract":"This article examines, within China’s complex healthcare sector, the extent to which China’s legal frameworks can adapt to a data-driven context that requires the reconciliation of public and private interests for the use of health data. Current data-processing mechanisms operate through individual consent, and administrative authorisation in mobile health settings are insufficient and ineffective to meet societal needs while simultaneously protecting individuals’ interests. In light of this shift of regulation from individual control to collective governance, this article argues that the principle of the right to health may complement this collective governance model. The right to health principle emphasises solidarity, justice, confidentiality, and collective responsibility, which may balance power asymmetries in the use of health data among different stakeholders. The article proposes a solution that incorporates the state’s obligation with private actors’ responsibilities, while stressing the importance of data sharing and the fair use of health data.","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"23 1","pages":"26 - 43"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44199453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The factors influencing the trajectory of Danish abortion law: From progressive to 50 years of stagnation","authors":"F. H. Pedersen, J. Herrmann, Laura TD Hansen","doi":"10.1177/09685332221119504","DOIUrl":"https://doi.org/10.1177/09685332221119504","url":null,"abstract":"In 1973, Denmark broke new ground when it introduced abortion as a legal right. We explore the drivers of Danish abortion law reform and demonstrate that liberalization was effectuated as the answer to a number of societal concerns. In observing the absence of autonomy as a winning argument for abortion law reform, we find that the Danish case is in alignment with the existing literature. Moreover, this article contributes to the understanding of how the historical drivers affect modern-day issues in abortion, including the fact that expansive autonomy for women is still not prioritized. Thus, we argue that liberalizing abortion regulation for reasons other than achieving reproductive autonomy comes at a price: downstream, it becomes difficult to achieve full autonomy in health law regulation because the initial reasoning behind liberalization continues to provide a certain framing even for present-day abortion issues. This observation can be of importance for those working in other jurisdictions to implement expansive autonomy in reproductive rights.","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"22 1","pages":"277 - 301"},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45435760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"On conscientious objection to abortion: Questioning mandatory referral as compromise in the international human rights framework","authors":"Zoe L. Tongue","doi":"10.1177/09685332221119503","DOIUrl":"https://doi.org/10.1177/09685332221119503","url":null,"abstract":"This article explores the approach of international human rights bodies to conscientious objection to abortion, by requiring states to implement mandatory referral mechanisms where conscientious objection is permitted. This, however, represents an inadequate compromise position as many objecting healthcare professionals also object to referral and circumvent those requirements. Furthermore, referral cannot address the broader issues with the overuse and misuse of conscientious objection provisions which obstructs access to abortion services. After considering the harms caused by conscientious objection and suggestions for alternative regulatory responses, this article proposes that the international human rights framework should aim to strike a contextual balance between freedom of conscience and ensuring access to abortion. This new approach should place clearer obligations on states to properly regulate conscientious objection, including obligations to address socio-cultural stereotypes around motherhood and the foetus, which result in widespread conscientious objection.","PeriodicalId":39602,"journal":{"name":"Medical Law International","volume":"22 1","pages":"349 - 371"},"PeriodicalIF":0.0,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41408719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}