{"title":"The two lives of the Mental Capacity Act: rethinking East-west binaries in comparative analysis.","authors":"Hillary Chua, Camillia Kong, Michael Dunn","doi":"10.1093/medlaw/fwae034","DOIUrl":"10.1093/medlaw/fwae034","url":null,"abstract":"<p><p>The Mental Capacity Act 2005 in England and Wales and Singapore's Mental Capacity Act 2008 (which substantially transplants provisions from the former statute) might appear to be twins on paper, but they have gone on to lead very different lives. In this article, we examine how two broadly identical laws have taken on divergent identities within their respective jurisdictions when implemented and interpreted in the courtroom. We reveal and analyse differences in parliamentary intent concerning at what stage a person's decision-making agency is putatively empowered; judicial development of central concepts; underlying socio-cultural commitments; and outline opportunities for bi-directional learning in mental capacity law across both jurisdictions.</p>","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142330817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A reparatory account of health inequities.","authors":"Michael Thomson","doi":"10.1093/medlaw/fwae044","DOIUrl":"https://doi.org/10.1093/medlaw/fwae044","url":null,"abstract":"<p><p>Colonialism has left biological and social legacies that damage health. The resulting racialized health inequities re-enact past harms and are a profound social injustice. In response, this article brings together reparatory justice and health equity. Understandings of reparatory justice have evolved from a focus on compensation for past wrongs to the need for a more sustained and expansive politics of repair. This seeks to recognize the history and legacies of harm while diminishing the likelihood that such harms are repeated. Addressing racialized health inequities in the UK, and working with this articulation of reparatory justice, this article argues for the repair of bodies that continue to be damaged by historically rooted harms. Social determinants of health research has long linked socio-economic inequalities to poor health outcomes, and promoting health equity by addressing these inequalities can be an important element of the work to repair the past. This response acknowledges the moral case for both reparatory justice and health equity, while potentially addressing problems faced by traditionally articulated reparatory claims. Finally, exploring law's role in addressing racialized health inequities can help us better understand how law is a determinant of health and its role in advancing health equity.</p>","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":"33 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intellectual property rights over 'integrated' medical devices: the potential health impacts and bioethical implications of rightsholders' control.","authors":"Aisling M McMahon, Opeyemi I Kolawole","doi":"10.1093/medlaw/fwaf001","DOIUrl":"10.1093/medlaw/fwaf001","url":null,"abstract":"<p><p>Despite extensive literature examining intellectual property rights (IPRs) and access to health, there has been limited examination of how IPRs can potentially impact the development, access to, delivery of, and use of medical devices. This article fills this gap, focusing on patent and copyright protections applicable to elements of medical devices that are attachable to or implanted into the human body, such as prostheses or pacemakers. Although the human body itself is not patentable in Europe (Article 5, Biotechnology Directive), elements of medical devices created outside the body are patentable. Moreover, certain aspects of such medical devices can be subject to copyright, and other types of IPRs. This article provides an overview of the types of IPRs that can apply over attachable and implantable medical devices. Following this, and focusing specifically on copyright and patent rights, it argues that such IPRs, alongside incentivizing technological development in certain contexts, also give rightsholders significant control over key aspects of how individuals use and access IP-protected elements of such devices, with the potential for health-related impacts and bioethical implications. Accordingly, the article argues that greater understanding and scrutiny are needed within the health law and bioethics communities around the potential impacts of IPRs over medical devices.</p>","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":"33 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The fifty shades of black: about black box AI and explainability in healthcare.","authors":"Vera Lúcia Raposo","doi":"10.1093/medlaw/fwaf005","DOIUrl":"10.1093/medlaw/fwaf005","url":null,"abstract":"<p><p>Artificial Intelligence (AI) is revolutionizing healthcare by enhancing patient care, diagnostics, workflows, and treatment personalization. The integration of AI in healthcare promises significant advancements and better patient outcomes. However, the lack of explainability in many AI models, known as 'black-box AI', raises concerns for patients, doctors, and developers. This issue, termed 'black box medicine', challenges the adoption of AI in healthcare. The demand for explainable AI has grown as AI systems become more complex. The absence of explanations in AI decisions, especially in critical situations like healthcare, has sparked debates and even suggestions to exclude black-box AI from healthcare provision. This article examines the impact and causes of unexplainable AI in healthcare, critically evaluates its performance, and proposes strategies to address this challenge.</p>","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":"33 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Legal fictions and complex lived realities: attributing legal parenthood in P V Q & F & X [2024] EWFC 85 (B)(FAM).","authors":"Anna Nelson","doi":"10.1093/medlaw/fwaf010","DOIUrl":"https://doi.org/10.1093/medlaw/fwaf010","url":null,"abstract":"","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":"33 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caroline A B Redhead, Catherine Bowden, John Ainsworth, Nigel Burns, James Cunningham, Søren Holm, Sarah Devaney
{"title":"Unlocking the promise of UK health data: considering the case for a charitable GP data trust.","authors":"Caroline A B Redhead, Catherine Bowden, John Ainsworth, Nigel Burns, James Cunningham, Søren Holm, Sarah Devaney","doi":"10.1093/medlaw/fwae043","DOIUrl":"10.1093/medlaw/fwae043","url":null,"abstract":"<p><p>The UK National Health Service general practice (GP) patient data constitute a rich research resource, but collecting, managing, and sharing patient data present challenges. In May 2021, to address these challenges, substantial changes to the system for processing pseudonymized GP patient data in England were announced. As part of an opt-out process, patient consent to sharing GP data was deemed to have been given. However, when over a million people quickly acted to opt out of the new system, the process was paused, and an engagement exercise commenced, whose aim was to inform a re-designed programme addressing patient concerns. In this article, we present and discuss the findings of the General Practice Data Trust pilot study, which has investigated people's reasons for opting out of sharing their data, and, looking for practical solutions to their concerns, has discussed with participants the concept of a 'data trust' to manage the sharing of patient data. Making a conceptual argument for the use of the (relatively new) charitable incorporated organization as a governance model for a GP data trust, we demonstrate how this could address patients' concerns and represent a more attractive means of stewarding GP data for research and service planning purposes.</p>","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prismall v Google UK Ltd [2024] EWCA CIV 1516: misuse of private information in the medical context.","authors":"Edward S Dove, Mark J Taylor","doi":"10.1093/medlaw/fwaf009","DOIUrl":"https://doi.org/10.1093/medlaw/fwaf009","url":null,"abstract":"","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":"33 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"G v Human Fertilisation and Embryology Authority [2024] EWHC 2453 (FAM): two distinct routes to posthumous fertility treatment.","authors":"Lisa Cherkassky, Emily Ottley","doi":"10.1093/medlaw/fwae046","DOIUrl":"10.1093/medlaw/fwae046","url":null,"abstract":"","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How best to regulate voluntary assisted dying: a qualitative study of perceptions of Australian doctors and regulators.","authors":"Ben P White, Casey M Haining, Lindy Willmott","doi":"10.1093/medlaw/fwae045","DOIUrl":"10.1093/medlaw/fwae045","url":null,"abstract":"<p><p>It is widely accepted that voluntary assisted dying (VAD) should be regulated but little is known about the most effective way to regulate doctors in this setting. This article reports on empirical research conducted in two Australian states where VAD is lawful (Victoria and Western Australia). Interviews were conducted with 92 participants: one group comprised doctors providing VAD and the other group was regulators in this field. Participants were asked about how best to regulate doctors providing this service. Strikingly, both regulator and doctor participant groups were consistent with each other in their views on what constituted effective regulation. The nature of VAD was perceived by participants to require special regulation, although some felt this was overdone in these states. Reported features of effective regulation included regulators taking an educative approach, regulation being perceived as acceptable by doctors, and it being responsive and nimble to provide the guidance that doctors need. Participants also considered a range of regulatory tools were required to regulate VAD effectively, and some identified a need for these tools to be employed together in a holistic way. This article concludes with a set of principles for effective regulation of VAD, discerned from the views of participants.</p>","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":"33 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11793166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Harnessing deliberative regulation to address inequities in accessing healthcare services in England.","authors":"Sabrina Germain, Gianluca Veronesi","doi":"10.1093/medlaw/fwae042","DOIUrl":"10.1093/medlaw/fwae042","url":null,"abstract":"<p><p>System-level decisions around the commissioning and provision of healthcare services in England have contributed to barriers in accessing the National Health Service. In this article, we ask how to better regulate resource allocation to ensure greater equity in access to healthcare services. First, we focus on the Health and Care Act 2022, which, drawing on principles of deliberative regulation to address health inequalities, initiates a shift away from previous regulatory approaches towards a collaborative decision-making model. We then shed light on the systemic factors creating and maintaining access barriers by considering shortcomings in previous regulatory approaches. With these in mind, we consider whether deliberative regulation-providing communities with resources to create normative solutions to intrinsic issues-could help address these systemic challenges. To assess the potential of laws or policies to achieve greater equity in healthcare, we also introduce an evaluative framework based on deliberative principles. We apply this framework to a case study of an Integrated Care System to gauge the extent to which the Health and Care Act 2022 has indeed been effectively adopting a deliberative approach by intentionally engaging marginalized communities in decision-making and devising accountability mechanisms for the allocation of healthcare resources.</p>","PeriodicalId":49146,"journal":{"name":"Medical Law Review","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}