Medical Law Review最新文献

Clinical trials of artificial placentas are anticipated; however, debate continues over how to define an artificially gestated entity, and little empirical research has explored stakeholder perspectives on this issue. This article presents findings from the first study in England to engage with healthcare professionals' perspectives. Healthcare professionals, as intermediaries between developers and patients, and clinical experts, are central to shaping technology integration into clinical practice. The analysis presented in this paper frames their views on the artificially gestated entity by different forms of 'location'. This illustrates how they align the entity with either a newborn or a foetus or propose interim definitions. The lack of consensus amongst healthcare professionals is shown to derive from their reliance on existing legal and medical frameworks. The significance of this article therefore lies in the evidence it provides that the current legal framework in England does not adequately support a consistent definition of an artificially gestated entity. Further, engagement with this stakeholder group reveals the practical implications that ambiguous definitions could have for clinical settings. This article argues that stakeholder groups must collaborate to develop regulatory frameworks for artificial placenta technology that support clinical integration and account for the interplay between law and medical practice.

This article explores the right of caregivers to wear religious dress in Europe, focusing on four countries: France, Belgium, the UK, and the Netherlands. It highlights the varying approaches to secularism, with stricter scrutiny on prohibitions in the UK and the Netherlands, while France and Belgium lean towards a form of outward neutrality that prohibits religious symbols, particularly in public services. While prohibitions on religious dress for caregivers might aim to protect the rights to equal treatment of patients, it raises concerns about its compatibility with equality law. Despite a shared European human rights framework, these policies result in inconsistent legal outcomes across countries, challenging the principles of non-discrimination and religious freedom. The article also questions the justification of blanket bans under health and safety standards, emphasizing the need for reasonable accommodation. Furthermore, it stresses that any restrictions on religious dress that are in place to protect the rights and freedoms of others should be based on objective, evidence-based reasoning. In this sense, patients' perceptions of religious symbols should not be generalized, especially considering the rights of minoritized or religious patients.

The HIV and AIDS Act was enacted in India in 2017 to protect the right to privacy, bodily autonomy, and non-discrimination of Persons Living with HIV (PLHIV). Prior to the Act, HIV/AIDS-related jurisprudence in India developed largely through judicial decisions on privacy, health care, queer rights, and marriage. This jurisprudence stigmatised PLHIV and constructed them as threats to society. The Act sought to respond to such characterisations and affirmed several rights of PLHIV that were previously denied. This article uses the reproductive justice framework to analyse the scope and potential of the Act in furthering sexual and reproductive freedoms of PLHIV and their partners. The article argues that despite the various rights and anti-discrimination protections under the Act, the law is insufficient to address the systemic and structural issues affecting PLHIV. The Act is premised on the problematic assumption that PLHIV are 'risky' sexual subjects, which affects the construction of rights and benefits. Furthermore, the Act does not, and arguably cannot, holistically address the problems faced by PLHIV in sexual, marital, and familial relationships. These constraints are a crucial reminder of the larger limitation of law as a blunt policy tool that is unable to comprehensively address complex socio-legal issues.

Concern for vulnerable people is a crucial issue when considering the legalization of assisted dying (AD), but the meaning and normative significance of vulnerability in this context is under-explored. We examine vulnerability and the protective obligation through the lens of vulnerability theory to improve understanding of vulnerability in the context of AD. By appealing to a more nuanced account of vulnerability, we argue that the current ban on AD in England and Wales is a blunt tool that lacks compassion and fails to recognize the importance of personal autonomy, as well as the relationship between vulnerability and autonomy. Recently, some emerging lawful models of AD purport to better protect the vulnerable via prospective legal authorization. This is also a feature of recent English Assisted Dying bills, with proposals for judicial or quasi-judicial authorization, and so we consider the potential value of prospective legal authorization. Although this approach risks being burdensome for applicants, we suggest that it could, in principle, not only safeguard vulnerable individuals, but also enhance end-of-life autonomy thereby offering support for a restrictive approach to lawful AD.

Euthanasia has been legal in Belgium since 2002. Despite extensive research exploring Belgian euthanasia practice, investigations into its governing regulatory framework are limited. Existing studies that consider regulation take a 'siloed' approach, generally considering sources of regulation individually, including euthanasia legislation and euthanasia policies. This study obtains insights from providing health professionals on how the Belgian euthanasia regulatory landscape influences their euthanasia practice. We conducted semi-structured, in-depth interviews from September 2022 to March 2024 with eligible physicians and nurses and analysed them using a reflexive approach to thematic analysis. We generated three overarching themes describing the influence of regulation on euthanasia practice: the Act is a valuable, boundary-setting instrument; but the Act is limited, leaving space for gap filling and other forms of regulation; and relying on professional judgment can make practitioners feel vulnerable. Key findings include that practitioners respond to the Act's non-prescriptiveness and regulatory lacunae by relying on their professional judgment, and that the efficacy of the retrospective euthanasia oversight model depends on physicians' good faith participation. Policymakers in Belgium and internationally are encouraged to reflect on the implications of Belgium's euthanasia regulatory model for the consistency, quality, and control of euthanasia practice.

Healthcare professionals have long expressed concern about their exposure to litigation if they allow consultations to be recorded. There has been little evidence available as to the validity of this concern. To address this gap and to inform policy and practice, this study examined 46 cases decided by Australian courts. It focused on the characteristics of these cases, as well as the admissibility, lawfulness, and impact of recordings. Most of the consultation recordings in these matters were made in the context of pre-existing conflicts, primarily involving personal injury, professional misconduct, and family law. Recordings had the greatest value in matters involving professional misconduct. In other matters, findings were mixed. Patients were often motivated to record by a lack of trust in their healthcare provider. The cases do not feature any consented recordings made for broader patient benefit, underscoring the view that lawful, mutually agreed recordings of healthcare consultations present a very low risk of adverse medico-legal consequences. Courts have treated consultation recordings variably, sometimes using discretion to admit recordings as evidence, even where they were obtained unlawfully. These cases support recent calls for allowing regular consultation recording and also demonstrate the value of recordings for patients and regulators, particularly in instances of professional misconduct.

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.

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.