Voices carry?:the voice of bioethics in the courtroom and voice of law in bioethics

This paper explores the interaction between bioethics and law in the theatre of the courtroom, with particular reference to English law. No matter what some judges say, the courtroom has long been a location in which law and bioethics interact, not least in seminal health care law cases such as Re A (Minors) (Conjoined Twins: Separation [2000] and R v Arthur [1981]. Judge-made law has made some positive contributions to the shaping of bioethics as a discipline, providing a real-world testing ground for moral arguments, issuing the judicial ‘products’ with which bioethics engages, and emphasising the importance of observing due process. At the same time, the courtroom is an adversarial arena, not always ideally suited to the resolution of ethical conflict, and its concern with actions that satisfy attainable standards can fall short of the aspirations set in philosophical ethics. Indeed, sometimes the judges misinterpret or wholly neglect the ethical dimensions of the case at hand. So much of what judges do involves orchestrated framing, the manipulation of legal concepts, interpretation (of the facts of the case, the story of legal precedent and of the particular ethical dilemma) and translation (of ethical issues into law's discourse). Whether they like it or not, the judges are interpreting and responding to the voice of bioethics alongside the voice of the law in their attempts to reach the 'right' judgment and in the face of the theatre surrounding cases involving bioethical controversy. The end result may be distorting because bioethical theory is misinterpreted or the voice of bioethics becomes obscured because of the drama of the case. But this is not to claim that bioethics has some access to the ‘right’ or ‘true’ response to the case at hand. Indeed, neither bioethics nor law can necessarily claim superiority or access to the ‘truth’ of the matter. We nevertheless argue that each will be likely to gain greater insight by opening a dialogue with the other, telling and re-telling the story, so that the voices of one forum can carry over into the other

Clinic, courtroom or (specialist) committee:in the best interests of the critically Ill child?

Law’s processes are likely always to be needed when particularly intractable conflicts arise in relation to the care of a critically ill child like Charlie Gard. Recourse to law has its merits, but it also imposes costs, and the courts’ decisions about the best interests of such children appear to suffer from uncertainty, unpredictability and insufficiency. The insufficiency arises from the courts’ apparent reluctance to enter into the ethical dimensions of such cases. Presuming that such reflection is warranted, this article explores alternatives to the courts, and in particular the merits of specialist ethics support services, which appear to be on the rise in the UK. Such specialist services show promise, as they are less formal and adversarial than the courts and they appear capable of offering expert ethical advice. However, further research is needed into such services – and into generalist ethics support services – in order to gauge whether this is indeed a promising development.</jats:p