Response to “A rose by any other name” published in the 2014 July edition of the Journal of Forensic and Legal Medicine

Dear Sir, We are grateful for the opportunity to reply to the comments made by Dr Davis. Our paper was developed in response to the common misunderstanding among forensic physicians of the roles of witnesses in the criminal courts and following reflection on the decision in Jones v Kaney. We indeed sympathise with Dr Davis' view that doctors who the courts recognise as “forensic physicians” should already have “prior knowledge and understanding of most of the information” outlined in our article

The Supreme Court and Assisted Suicide

The Supreme Court and Assisted Suicide: A Commentary on R (on the application of Nicklinson and another) v. Ministry of Justice; R (on the application of AM) v. DPP [2014] UKSC 3

Losing Faith in the Dead Donor Rule

According to the Dead Donor Rule (DDR), vital organs can only be removed from donors who are already dead. Organ procurement, in other words, must not be the cause of their deaths. The rule purports to protect dying and vulnerable individuals from being sacrificed for the benefit of other people who are in need of those organs. This notion that innocent human beings should not be used as means to an end is undoubtedly a concern that is unequivocally shared by Abrahamic faith communities. In this regard, the philosophy and rationale of the DDR fully cohere with their religious teachings. However, the method by which death is officially diagnosed to determine when an individual qualifies as a dead donor is not one that they necessarily share. Whilst English law recognises death as having occurred when the brainstem is dead, these faith communities ordinarily associate death with the departure of the soul. The latter is signified by the cessation of breathing and heartbeat. From this perspective, a person is still alive as long as they are still breathing even if this function is rendered possible only through artificial ventilation. Since it is currently lawful to remove the vital organs of mechanically-ventilated brainstem dead persons without contravening the DDR, it will be argued that the rule does not adequately protect the welfare of Christians, Muslims and Jews in the UK. The article ends by making recommendations on how their faith in the DDR could be restored

Charlie Gard and Alfie Evans: Their Medico-Legal Journeys

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Preface

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The Medical Practitioners' Tribunal Service: One Year On

In June 2012, the General Medical Council (GMC) instituted a series of new rules that reformed their fitness to practise work. The most significant change to disciplinary proceedings was the formation of a Medical Practitioners Tribunal Service (MPTS) which is led by a former Deputy High Court Judge. Aimed at safeguarding patient safety, the MPTS is an autonomous part of the GMC which will now adjudicate on all cases relating to doctors whose fitness to practise is called into question. With the new development, the GMC will continue to collect evidence and carry out the investigations, but the cases will be adjudicated by the tribunal which is empowered to impose sanctions against doctors’ registration. The fitness to practise panels which sit on these hearings are made up of medical and lay members who receive specific training and are regularly appraised. The hearings are conducted in public and the tribunal is accountable to Parliament. The GMC had hoped that the change would bolster public and professional confidence that these hearings are impartial, fair and transparent. They have described the change as “the biggest shake-up of fitness to practise hearings since they were first established in 1858” (GMC Press Release, 11 June 2012). This paper takes a look at the profile of the cases which the MPTS heard in the first year of its operation and assesses its scope for improving patient safety

Disorders of Consciousness: Is a Dichotomous Legal Approach Justified?

Advances made in medical care mean that many critically ill patients with an acquired brain injury may survive with a disorder of consciousness. This may be in the form of a vegetative state (VS) or a minimally conscious state (MCS). Medically, there is a growing tendency to view these conditions as occupying the same clinical spectrum rather than be considered as discrete entities. In other words, their difference is now understood as one of degree rather than kind. However, is English law keeping pace with this development in medical knowledge? This article seeks to highlight the duality that exists in the legal decision-making process in England and Wales, and question the justifiability and sustainability of this dichotomous approach in the light of medicine’s current understanding on disorders of consciousness

Can "Medical Futility" Conflicts be Mediated?

Mr Justice Francis ended his judgment in Great Ormond Street Hospital v Yates, Gard and Gard with the recommendation that ‘mediation should be attempted in all cases such as this one’. Although this gave the impression that mediation would be unquestionably beneficial in the Gard case and other ‘medical futility’ cases where the patient is incompetent, this paper contends that this is not as straightforward as it might at first appear. With the general absence of a middle groundandwiththelawinsuchcasesfrequentlyondoctors’side,mediation’spotential for a satisfactory resolution of medical futility conflicts is arguably limited