Some doctors are set to argue against moves towards an organ donation system of presumed consent in the UK. Under presumed consent all people are assumed to be willing to donate their organs unless they have opted out. No part of the UK has introduced such a system yet, although the Welsh assembly favours the idea. However, delegates at the British Medical Association's annual conference in Cardiff will debate later whether the move could damage trust in doctors. Those in favour of presumed consent, which has been supported by the BMA for the last 10 years, believe it would help boost UK donation rates, which, despite recent improvements, still lag behind many other countries.
A 22-stone ex-policeman trying to persuade a health authority to fund obesity surgery started the latest round of his legal fight today. Grandfather Tom Condliff, of Talke, Staffordshire, who is 62 and 6ft 2in, says he needs stomach surgery to save his life. But the North Staffordshire Primary Care Trust (PCT) refuses to fund a laparoscopic gastric bypass operation. In April, the High Court refused to quash the PCT's decision not to provide the surgery. Today, Mr Condliff's lawyers sought to overturn the High Court ruling in the Court of Appeal.
The ‘elusive’ concept of ‘impairment’ was introduced into the General Medical Council's Fitness to Practise Procedures in 2002. Its function was ostensibly to bring all forms of fitness to practise allegations against doctors under a unifying concept and thereby reduce procedural complexity. This paper strives to illuminate the application of ‘impairment’ of fitness to practise with reference to a year of fitness to practise decision making by the General Medical Council (GMC). It concludes that impairment has brought with it a redemptive style of resolving matters of
However, further advances are under threat in the UK from inflexible laws, cumbersome licence requirements and fear of liability. Here we report a sequence of events that led to a UK clinical scientist withdrawing from participation in an international transplant research study in receipt of research ethics approval. We highlight the difficulties encountered and discuss possible solutions which, we believe, would promote legitimate research in the interest of the common good. We also contend that the current human tissue legislation should be replaced by a legal framework more responsive to the importance of scientific innovation for clinical service development in this field.
This paper explores the issue of donation of organs from deceased donors for transplantation into a specified recipient. It argues that proper account should be taken of the principles underlying the Human Tissue Act 2004, which grant the donor a form of proprietary control. Three hypothetical scenarios are then used to draw out the implications of these principles for existing regulatory policy and the common law response to excised human organs. The paper concludes that the law should be understood as recognising ownership in organs removed from living and deceased persons and as offering opposition to the prohibition of directed donation that can only be coherently removed by reform of the 2004 Act.
A 22-stone ex-policeman has lost his Court of Appeal fight to force a health authority to fund obesity surgery. Tom Condliff, 62, said he needed a gastric bypass operation to save his life after becoming obese due to the drugs he takes for long-term diabetes. The Stoke-on-Trent man challenged a decision by North Staffordshire PCT to refuse to fund the procedure. Court judges expressed "considerable sympathy" but ruled the funding policy did not breach human rights laws. Lord Justice Toulson, one of three judges sitting on Wednesday, said: "Anyone in his situation would feel desperate." Mr Condliff, of Talke, who has a body mass index (BMI) of 43 - not high enough under his PCT's rules to qualify for surgery - lost a High Court battle over the decision in April. But his lawyers had argued the PCT had applied a funding policy which was legally flawed and breached his human rights.
Doctors could risk losing their licence if they fail to report fitness to practise concerns about their colleagues, MPs have recommended. In its first annual review of the functions of the General Medical Council, the House of Commons Health Committee has called for the regulator to send “a clear signal” to doctors that they are at as much risk of being investigated for failing to report concerns about a fellow doctor as they are from poor practice on their own part. Senior doctors and clinical team leaders in hospitals would be most accountable, but there would be “questions asked of everybody,” said Stephen Dorrell MP, chair of the health committee.
The extent to which people should be able to have some control over how and when they die is a hugely contentious issue. In 2006, the House of Lords blocked Lord Joffe’s bill that would have allowed terminally ill people in certain circumstance to be helped to die. Yet there is little robust and impartial evidence about the attitudes of people in Britain towards these issues. To find out more about what people think, the 2005 British Social Attitudes survey included a set of questions about attitudes to assisted dying and end of life care.
At 63, Pratchett — who has been diagnosed with early-onset Alzheimer's — speaks openly about causing his own death. "I believe everyone should have a good death," he tells NPR's Steve Inskeep. "You know, with your grandchildren around you, a bit of sobbing. Because after all, tears are appropriate on a death bed. And you say goodbye to your loved ones, making certain that one of them has been left behind to look after the shop." Pratchett has become an advocate for legalized assisted suicide in Britain, making him one of many voices in a global debate. Many oppose the practice for religious reasons or because they fear a slippery slope to involuntary euthanasia; but Pratchett has turned the legalization of assisted suicide into something of a personal crusade.
A 46-year-old-man who wants to die after a stroke that left him almost completely paralysed is bringing a groundbreaking legal action that could effectively lead to the legalisation of assisted suicide in the UK. Martin was a fit and active man who enjoyed rugby, cars and socialising with friends in the pub before suffering a brainstem stroke three years ago. Now requiring round-the-clock care, his mobility is limited to moving his eyes and small movements of his head. He communicates by staring at letters on a computer screen which the machine recognises and forms into words spoken by a digitised voice. Martin has been asking to die since six months after the stroke but says he has no one willing to assist him and cannot on his own organise a trip to the Swiss clinic Dignitas, where he could end his life legally. His wife, who chooses to be known as Felicity, says she will be with him if he dies but will not help bring about his death.
At least one in 10 suicides in England is by someone with a chronic or terminal illness, found researchers who tried to obtain information on the subject from local health authorities. Coroners told them that people were increasingly killing themselves at a younger age, rather than waiting until they were in severe pain in their 80s or 90s. And two of 15 coroners interviewed also indicated they deliberately avoided probing into possible cases of assisted suicide - which remains illegal in Britain - "often for fear of causing problems for the friends and family left behind".
Anti-abortion campaigners are pressing ahead with a controversial amendment to the Government’s new health bill designed to cut the number of pregnancies which are terminated each year in the UK. The Conservative MP Nadine Dorries, who is proposing the amendment, said yesterday she would not be “bought off” by the promise of a Government consultation on whether or not to offer independent counselling to all women considering an abortion. Instead she said she wanted to change the law to strip abortion charities and doctors of their exclusive responsibility for counselling women seeking to terminate a pregnancy, and hand it to specially trained professionals.
The husband of a woman who died in one of Britain's best-known hospitals is taking its management and the health secretary Andrew Lansley to court, alleging an illegal use of "do not resuscitate" orders. David Tracey claims doctors at Addenbrooke's hospital, Cambridge, twice put such orders in his wife's medical notes, cancelling the first after she objected to it only to put in a second three days later without her consent or any discussion with her. Tracey alleges the hospital's actions deprived his 63-year-old wife Janet of the right to life and subjected her to degrading treatment, while he was denied respect for his personal and family life. He is also seeking to force the coalition government to draw up a policy for England on the use of Do Not Attempt Cardio-pulmonary Resuscitation (DNACPR) instructions, and claims the present system of local policies is open to abuse.
Terminally ill patients who want to commit suicide should be able to receive medical help to die, a government adviser on care for the elderly has said. Martin Green, a dementia expert for the Department of Health, said patients who were too frail to take their own lives were being denied “choice” and “autonomy” because assisted suicide is illegal in the UK. In an interview with The Daily Telegraph, he urged ministers to review the law and suggested that a referendum or a free vote in Parliament should be called to settle policy on the issue. “If you’re going to give people ‘choice’, it should extend to whether or not they want to die,” he said.
'A new pathway for the regulation and governance of health research' was published in January 2011. The report was prepared by a working group, chaired by Professor Sir Michael Rawlins FMedSci, convened in response to an invitation from Government to review the regulation and governance of UK health research involving human participants, their tissue or their data. The report proposes four key principles that should underpin the regulation and governance framework around health research in the UK, and makes recommendations to: * Create a new Health Research Agency (HRA) to rationalise the regulation and governance of all health research. * Include within the HRA a new National Research Governance Service to facilitate timely approval of research studies by NHS Trusts. * Improve the UK environment for clinical trials. * Provide access to patient data that protects individual interests and allows approved research to proceed effectively. * Embed a culture that value
A man who is almost completely paralysed is taking legal action in a bid to end his life. His solicitors have told the BBC that they believe his case could have major implications for the way prosecutors in England, Wales and Northern Ireland deal with assisted suicides.
Frances Swaine and Merry Varney are instructed by David Tracey, whose wife, Janet Tracey, sadly died in Addenbrooke’s Hospital on 7 March 2011. Following her admission to Addenbrooke’s, a ‘Do Not Attempt Cardio Pulmonary Resuscitation Order’ (known as a DNACPR or DNR) was placed on Janet’s medical notes. Janet was unaware of the DNACPR and when she became aware of it several days later, she clearly stated it was against her wishes and that she wanted to be resuscitated. As a result the DNACPR was cancelled. Several days later however a further DNACPR was entered onto her records. We have issued a judicial review and human rights claim against the NHS Trust responsible for Addenbrooke’s and against the Secretary of State for Health seeking Declarations from the Court that the Trust’s policy on the use of DNACPR is unlawful, and for the Secretary of State for Health to issue national guidance for patients and their families to know their rights concerning the use of DNACPRs.
In 2009 the legislature, judges & DPP each turned their attention to issues around assisted suicide. The legislature decided not to change the law. The judges decided the existing law was insufficiently clear & required the DPP to clarify it. The DPP flirted with reforming the law, but then drew back from such a legislative role. His published policy has been considered as a contribution to the regulation of death & dying, & as such has been found wanting. However, considered in the context of the proper roles of Parliament, courts & prosecutors, & seen as an exercise in constitutional restraint, the DPP's approach should be appraised rather differently. From this perspective, the decision of the HL in Purdy raises significant concerns for the legitimacy of decision making in the contested moral issues that arise in healthcare ethics. In our democracy, courts should be wary of usurping legislative authority in areas where the Parliamentary position is clear. …
Tony, 47, and Barrie Drewitt-Barlow, 42, of Chandlers Quay, Maldon, who were Britain's first gay surrogate parents, denied one charge of providing false information to an ethics panel. The pair, who ran Euroderm Research, also deny two counts of not conforming to protocol when conducting a trial. The pair appeared before Southwark Crown Court on Wednesday. They also deny two charges of conducting a clinical trial otherwise than in accordance of good clinical practice.
On the face of it, the decision by a High Court judge in the case of M is no surprise - few would have expected a ruling to allow a patient with any level of consciousness and feeling to die. But a closer inspection of the 76-page judgement shows that Mr Justice Baker did not find his decision a straightforward one.
When Penny Wark's brother died last year, her family did not hesitate to donate his organs. Despite the trauma, she thinks it was the right decision - but says grieving relatives must be treated with more care.
This paper examines the historical role of law and politics in the adoption of smallpox vaccination in Britain, focusing primarily on the early Victorian period, when legislation was passed to enforce compulsory infantile vaccination. The primary thesis of the study is that law, and the processes through which it is created and maintained, provide a distinct “envelope of social order” (Jasanoff 2008, 764) within which competing and duelling interests and opinions about scientific innovation find origin, expression, and debate. Consequently, the manner in which law responds to science and its impact on society is neither static nor self-evident, but subject to mutable circumstances that are historically, politically, and socially situated. The paper is divided into two main parts. The first provides a brief history of vaccination and the second focuses on events surrounding the introduction of compulsory vaccination laws in England and Wales.
Sir Terry Pratchett, the fantasy writer who was diagnosed with Alzheimer's in 2008, said yesterday he had started the formal process that could lead to his own assisted suicide at the Dignitas clinic in Switzerland. Pratchett, whose BBC2 film about the subject of assisted suicide is to be shown on BBC2 tomorrow, revealed he had been sent the consent forms requesting a suicide by the clinic and planned to sign them imminently. "The only thing stopping me [signing them] is that I have made this film and I have a bloody book to finish," he said during a question-and-answer session following a screening at the Sheffield documentary festival Doc/Fest. He said that he decided to start the process after making the film Terry Pratchett: Choosing to Die, which shows the moment of death of a motor neurone sufferer, millionaire hotel owner Peter Smedley.
Pregnant women who ask for a Caesarean delivery should be allowed to have the operation, even if there is no medical need, according to new guidelines for England and Wales. The National Institute of Health and Clinical Excellence (NICE) states that women should be offered counselling and told of the risks first. Ultimately, however, the decision would be made by the mother-to-be, it said.
Most senior doctors in England and Wales feel that rational suicide is possible. There was no association with specialty. Strong religious belief was associated with disagreement, although levels of agreement were still high in people reporting the strongest religious belief. Most doctors who were opposed to physician assisted suicide believed that rational suicide was possible, suggesting that some medical opposition is best explained by other factors such as concerns of assessment and protection of vulnerable patients.
Tom Condliff, who weighs 22st, was not considered fat enough to have a gastric bypass operation by his local Primary Care Trust and both the High Court and the Appeal Court ruled that its decision was lawful. But less than a month after his latest setback, the 62 year-old from Staffordshire has been told that his latest “individual funding request” has been successful on the grounds of his exceptional circumstances and he will now be treated. He told the BBC: “I am very, very pleased about the PCT's decision but at the same time I am rather concerned that I haven't changed since the last time the request for IFR in September last year, was put in. “It was turned down then. So I don't know why it has been granted this time. “I am looking forward to being able to get out of the house and to enjoying myself and having a decent quality of life.”
My name is Geraldine McClelland and I have chosen to die today [7 December]. I am 61 years old and am dying from lung and liver cancer, which metastasised from my breast cancer two years ago. The lung cancer is now causing me serious breathing problems, meaning I am largely confined to my flat. I have chosen to travel abroad to die because I can not have the death I want here in the UK. I would like to be able to choose to take medication to end my life if my suffering becomes unbearable for me, at home, with my family and friends around me. But the law in this country prevents me from doing so. As a result I am travelling abroad to take advantage of Switzerland's compassionate law.
“The current legal status of assisted dying is inadequate and incoherent...” The Commission on Assisted Dying was set up in September 2010 to consider whether the current legal and policy approach to assisted dying in England and Wales is fit for purpose. In addition to evaluating the strengths and weaknesses of the legal status quo, the Commission also set out to explore the question of what a framework for assisted dying might look like, if such a system were to be implemented in the UK, and what approach to assisted dying might be most acceptable to health and social care professionals and to the general public.
A woman died after an experienced surgeon unintentionally attempted to take out the wrong organ during an operating theatre complication. Amy Joyce Francis, 77, was due to have a kidney removed at the Royal Gwent Hospital in July 2010 but instead the surgeon tried to remove her liver. The woman from Newport suffered a fatal heart attack after a loss of blood. The coroner recorded a narrative verdict which was fully accepted by the Aneurin Bevan Health Board.
The treatment of inherited mitochondrial abnormalities in human embryos using donor mitochondria is an advancing area of research. The techniques involved could have profound implications for future generations. This project will explore the ethical issues relevant to affected families, potential donors, researchers, medical professionals and others trying to understand and respond to the therapeutic possibility of mitochondrial transfer.
A man who was virtually paralysed by a stroke has won the first step in his legal bid to pursue his right-to-die. Known only as Martin, he would require professionals to help as his wife has said she will not assist him. But current guidance suggests they may be prosecuted, where loved ones would not, and Martin's case is this discriminates against him. This High Court judgement means lawyers and doctors can discuss assisted dying with him, but only to prepare his case.
The Commission on Assisted Dying, set up in September 2010 and chaired by former Lord Chancellor Charles Falconer, has issued its monumental report on assisted dying in England and Wales. The Commission was funded by two supporters of assisted suicide, author Terry Pratchett and businessman Bernard Lewis, and despite reassurances that the running and outcome of the Commission were independent, some individuals and groups opposed to the practice regrettably refused to give evidence to the Commission. Still, the range and quantity of the evidence, which included evidence gathered from international research visits, qualitative interviews and focus groups, commissioned papers, and seminars, is impressive and can be read and watched here.
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