Medical Law Review最新文献

Mental health and capacity laws applicable to children and young people in Northern Ireland (NI) lack clarity and coherence, with significant gaps in service provision and safeguarding. Drawing on an examination of such laws, we argue that law reform is needed. In the short term, we suggest there is merit in publishing statutory guidance, such as a Code of Practice, to address both the issue of evolving capacity in children and to facilitate best practice in policy and practice. This modest reform in the short term should be accompanied by a firm political commitment to ensuring that NI's innovative fusion mental capacity legislation is fully brought into force in the medium term. Meanwhile, law reform should form part of a holistic approach on the part of NI's policy-makers towards improving mental healthcare provision for children and young people in line with a human rights-based approach. This would include the following: increased allocation of funding and resources to facilitate more timely access to suitable treatment and related services; enhancing participation in policy, judicial, and clinical decision-making that impacts their lives; and employing a range of executive accountability mechanisms to drive improvements in such provision over time.

One of this century's most dramatic scientific developments is the reprogramming of stem cells in order to create organoids, that is, self-organizing 3D models that mimic the structure and function of human organs. This article considers whether brain organoids in particular might raise any new questions for law, now or in the near future. If complex human brain organoids were to become capable of consciousness or sentience, the current regulation of human tissue research, which protects the interests of tissue donors, might need to be supplemented in order to protect the interests of the tissue itself. Human brain organoids can also be implanted into animal hosts, and if this were to result in animals with significantly enhanced cognitive abilities, additional protective measures might become necessary.

Some jurists claimed there was a common law power to dissect the human body prior to and outside of the Anatomy Act 1832. That power formed part of the privileges of physicians, surgeons, and apothecaries, and, accordingly, the common law to the extent it recognized those privileges. It is best evidenced in the late-nineteenth and early-twentieth centuries-most authoritatively by the Court of Queen's Bench in R v Price in 1884, the Québec Superior Court in Phillips v Montreal General Hospital in 1908, and the reasons of the inquiry into the conduct Dr William Ramsay Smith in 1903, but also in the comments of writers in law manuals until the mid-twentieth century. The existence of a common law power to dissect challenges narratives ordinarily told about the history of anatomy law specifically and the law of the dead generally. The power may also still exist if legislation in a jurisdiction has not displaced or substantially altered it. Through medico-legal history, the author argues that the medical lawyer can benefit from re-examining old doctrines. Heterodox elements in old doctrines suggest alternative possibilities for the law, allowing medical law's histories to be retold.

This article adds to the still limited scholarship on the impact of abortion laws and policies on people with disabilities and those with diminished capacity who seek abortion. We argue that neither the legal nor policy framework currently operating in England and Wales adequately incorporates and protects the rights of people with disabilities or those experiencing mental ill-health. Rather, the law and policy framework jeopardizes their reproductive agency. We argue that greater attention to and incorporation of standards contained within the UN Convention on the Rights of Persons with Disabilities (including the sources produced by its Committee) and implementation of guidelines produced by the World Health Organization would result in a rights-affirming framework that supports disabled women's reproductive agency, enhances their effective enjoyment of human rights, and supports them in accessing quality abortion care.

The emergence of FemTech technologies promises to revolutionize women's health and reproductive rights but conceals an insidious trap of surveillance and control in the hands of private and state actors. This article examines the extent to which FemTech technologies, under the guise of empowerment, enable private actors to play a leading role in managing reproductive rights, replacing largely inactive States in this crucial function. The analysis shows how private FemTech companies are becoming critical players in implementing and defending these rights, often in response to the inaction or inadequacies of States. The article approaches the FemTech phenomenon from several angles, including the promises of empowerment, concerns about surveillance and control, and the ambivalent roles of private actors as implementers and defenders of reproductive rights. This structure makes it possible to offer a critical analysis of the legal, societal, and ethical implications of FemTech, highlighting the tensions between the promises of empowerment and the risks of surveillance and control.

In Australia and the UK, commercialization and corporatization of assisted reproductive technologies have created a marketplace of clinics, products, and services. While this has arguably increased choice for patients, 'choice', shaped by commercial imperatives may not mean better-quality care. At present, regulation of clinics (including clinic-corporations) and clinicians focuses on the doctor-patient dyad and the clinic-consumer dyad. Scant attention has been paid to the conflicts between the clinic-corporation's duty to its shareholders and investors, the medical profession's duty to the corporations within which they practice, and the obligations of both clinicians and corporations to patients and to health systems. Frameworks of regulation based in corporate governance and business ethics, such as stakeholder models and 'corporate social responsibility', have well-recognized limits and may not translate well into healthcare settings. This means that existing governance frameworks may not meet the needs of patients or health systems. We argue for the development of novel regulatory approaches that more explicitly characterize the obligations that both corporations and clinicians in corporate environments have to patients and to society, and that promote fulfilment of these obligations. We consider mechanisms for application in the multi-jurisdictional setting of Australia, and the single jurisdictional settings of the UK.

In this article, using theories of procedural justice and 'slow violence', we consider potential reform of the Human Fertilisation and Embryology Act 1990. Our theoretical discussion is underpinned by findings from the ConnecteDNA project, exploring how people affected by donor conception experience direct-to-consumer genetic testing (DTCGT). The negative impacts of DTCGT, especially shock discoveries about the circumstances of someone's conception in adulthood, are linked to donor anonymity, and how its continued protection is experienced as a barrier to the rights and agency of donor-conceived people. We focus on two key issues relating to the donor information access process set out in section 31ZA of the 1990 Act. The first is that it excludes certain cohorts of donor-conceived people, creating inequalities of access to donor information. The second is the impact of the use of DTCGT to search for that information. We discuss what a procedurally just process of law reform would look like, concluding that, whatever (prospective) approach to donor anonymity is taken, the donor information access process should be the same for all donor-conceived people. We thus argue that, even were the status quo to be maintained, reform of the donor information access process with retrospective effect would be required.