Medicine and Law

Surgical castration of sex offenders has been used in several countries to prevent sexual recidivism and is still practiced in several states in the United States. In Europe, it has remained in limited use in Germany and in the Czech Republic (Douglas et al. 2013). Since the 1960s, most jurisdictions have replaced irreversible surgical castration of sex offenders with reversible chemical castration with anti-androgen drugs. In Denmark, use of surgical castration was stopped in 1970, and since the late 1980s, serious (...) sex offenders have on a trial basis been treated with anti-androgen drugs (Hansen and Lykke-Olesen 1997). In 1997, an official treatment program for sex offenders was introduced on a trial basis, and in 2011 this scheme was made permanent (Nielsen 2001).The first part of the scheme covers persons with a suspended sentence with conditions of sexological treatment. This program serves as an alternative to suspended sentences of up to one and a half years of prison for crimina. (shrink)

a relatively more sympathetic attitude among younger judges, many of them women, and among trainees, may reflect a historical evoluti.

El libro titulado “los avances del Derecho ante los avances de la medicina”, fruto de un Congreso internacional organizado por la Universidad Pontifica Comillas de Madrid en junio de 2008, recoge numerosos trabajos científicos en torno a cuatro grandes ámbitos en los que el legislador y el juzgador español están haciendo avanzar el Derecho al compás del avance en la ciencia médica: avances en la responsabilidad medica tanto civil, como patrimonial y penal; avances en la tutela de los derechos de (...) los pacientes, avances en los desafios jurídicos que plantea la investigación biomédica y avances en la seguridad de los pacientes. (shrink)

We are more alike than we are different.In male prisons, the agency and antisocial mindset of violent offenders is taken seriously in the pursuit of rehabilitation. Male offenders are expected to own full agency for their cruelty and violence to others, and to explore it in supported rehabilitative group-work programs. Such programs have been shown to be highly effective for some offenders and relate to a process of engaging with a new pro-social identity and taking responsibility for leading a "good (...) life."Such programs hardly exist for violent women. Psychological services in female prisons rarely offer programs on anger management or opportunities to explore the wish to hurt or control; rather, they emphasize .. (shrink)

The liberal approach to ethics quite naturally tends toward the classic individualistic theory of society, to reductionism or psychologism so-called, that is, to a reduction of all social action to individual action. For example, liberalism allows one to experiment with new medications on one's own body. By extension, liberalism allows one to experiment, it seems, on another person's body with new medication if one acts as the other person's agent, that is, if one has the other person's proper consent. We (...) all know that new medicines are introduced into the market experimentally; indeed, government agencies, such as food and drug administrations, are supposed to supervise such experimentations and eliminate from the market as quickly as possible new (or old) medications that prove harmful. Hence, the very introduction of a new medicine into the market requires the consent of the public - in the form of proper permits to manufacture and market new (and old) drugs and other medications. Yet there is a flaw in this description. The act of permission is not made by individual citizens to doctors who act as their agents. (shrink)

Scholars have mostly analyzed information from mental health practitioners, attorneys, and institutions to critique mental health practices in the War on Terror. These sources offer limited insights into the suffering of detainees. Detainee accounts provide novel information based on their experiences at Guantánamo. Mohamedou Ould Slahi’s Guantánamo Diary is the only text from a current detainee that provides a first-person account of his interrogations and interactions with health professionals. Despite being advertised as a diary, however, it has undergone redaction from (...) American government officials. This article examines Slahi’s account of his interrogations and representations of mental health at Guantánamo and considers its role within the narrative function of the nation. At stake is the right of detainees to narrate, scholars to critique medical practices in the War on Terror, and the nation’s attempts to control its narration. (shrink)

The proliferation of ethics committees and ethics consultation services has engendered a discussion of the issue of the expertise of those who provide clinical ethics consultation services. In this paper, I discuss two aspects of this issue: the cognitive dimension or content knowledge that the clinical ethics consultant should possess and the practical dimension or set of dispositions, skills, and traits that are necessary for effective ethics consultation. I argue that the failure to differentiate and fully explicate these dimensions contributes (...) to the confusion over the issue of expertise and fuels, at least partly, the controversies about expertise (or authority) in ethics and the legitimacy of the use of ethical knowledge in clinical ethics consultation. (shrink)

A discussion of the ethics of stem cell research, and attempts to regulate it.

Governments across the globe have squandered treasure and imprisoned millions of their own citizens by criminalising the use and sale of recreational drugs. But use of these drugs has remained relatively constant, and the primary victims are the users themselves. Meanwhile, antimicrobial drugs that once had the power to cure infections are losing their ability to do so, compromising the health of people around the world. The thesis of this essay is that policymakers should stop wasting resources trying to fight (...) an unwinnable and morally dubious war against recreational drug users, and start shifting their attention to the serious threat posed by our collective misuse of antibiotics. (shrink)

Review of a book on brain death and organ transplantation.

Sono discusse le principali argomentazioni medico-biologiche che costituiscono il nucleo della teoria secondo la quale la morte cerebrale totale corrisponde alla morte dell'essere umano. Speciale attenzione è riservata alla normativa che disciplina l’applicazione dei criteri per l'accertamento di morte e alle critiche che hanno mostrato come attualmente la teoria che fa da sostegno a quella normativa sia stata radicalmente messa in discussione.

I explain why I think that considerations regarding the opposing rights involved in the practice of circumcision—rights of the individual to bodily integrity and rights of the community to practice its religion—would not help us decide on the desirable policy towards this controversial practice. I then suggest a few measures that are not in conflict with either religious or community rights but that can both reduce the harm that circumcision as currently practiced involves and bring about a change in attitude (...) towards the practice, thus further reducing its frequency. These measures are the compulsory administration of anaesthetics; the banning of the metzitzah b’peh; and having an upper age limit of a few months on nontherapeutic circumcision of minors. I conclude with general considerations on why the steps taken towards the reform of circumcision should be moderate. (shrink)

The book explores and explains the relationship between law and ethics in the context of medically related research in order to provide a practical guide to understanding for members of research ethics committees (RECs), professionals involved with medical research and those with an academic interest in the subject.

This article explores the effectiveness of legal interventions to promote healthier eating/drinking and exercise in responding to obesity. Undue emphasis on weight loss and prevention of excess gain have largely been failures and have fueled prejudice against fat people. A major challenge lies in shifting norms: away from stigmatization of the obese and towards more nutritious eating/drinking and increased activity with acceptance of bodies in all shapes and sizes. Part of the enormity of this challenge lies in the complex effects (...) of law and its relationship with norms, including unintended consequences of regulation. To illustrate such complications, the paper examines two interventions and the actual effects that they have produced (or could under differing conditions): junk food taxes, particularly on SSBs (sugar sweetened beverages), and restriction of advertising to children, especially the ban in Quebec. (shrink)

This paper tells the story of a recent laboratory medicine controversy in the Canadian province of Newfoundland and Labrador. During the controversy, a DAKOAutostainer machine was blamed for inaccurate breast cancer test results that led to the suboptimal treatment of many patients. In truth, the machine was not at fault. Using concepts developed by Bruno Latour and Pierre Bourdieu, we document the changing nature of the DAKO machine’s agency before, during, and after the controversy, and we make the ethical argument (...) that treating the machine as a scapegoat was harmful to patients. The mistreatment of patients was directly tied to a misrepresentation of the DAKO machine. The way to avoid both forms of mistreatment would have been to include all humans and nonhumans affected by the controversy in the network of decision-making. (shrink)

The author examines Ireland's Supreme Court decision in the X case and its effects on this country's constitutionally entrenched position of fetal rights. This decision is found to be inadequate for women’s groups and their supporters because of the Court’s adoption of ‘proper candidates’ for abortions. The Irish government’s subsequent efforts to strike a balance between the competing interests only serve to create more ambiguity in determining the legal status of abortion in Ireland. Further, the legal amendments and judicial interpretation (...) of the X case have not substantially liberalized Ireland’s abortion policy, creating opportunity for more feminist discourse and activism. Finally, the proposed referendum in 2002 is summarized and the issues left unresolved by the government’s proposal are examined. The author outlines’ the risks of encroachment on the already limited rights to Irish women’s reproductive freedoms and bodily integrity. (shrink)

Protecting the Vulnerable explores the reality of patient control and choice in health care and analyzes how decisions should be made on behalf of those deemed incapable of making decisions. The contributors, distinguished experts from the disciplines of medicine, ethics, theology, and law, look at the complex problem of autonomy and consent in health care and clinical research today from an illuminating perspective--its impact on the vulnerable members of society. The essays move from the exploration of lingering paternalism in health (...) care to the acute dilemma of treatment of and research on newborn babies. In covering both general and specific problems the collection reveals how exploitation can occur when the right of autonomy is eroded and where informed consent is illusory. Particularly vulnerable groups, such as children and people with mental handicaps, are discussed alongside cases where the vulnerability is itself an issue. Other areas covered include: `gesture' suicides, the practical problems of doctors in dealing with dependent patients, and the limits of proxy consent. All health care professionals, ethicists, policy makers, and lawyers currently engaged in the study or practice of health care ethics will find Protecting the Vulnerable to be a vital source of information for many years to come. (shrink)

PREFACE Ubi bene, ibi patria. The proverb expresses an important feature of this book. 'Being somewhere' necessarily implies an orientation towards ...

The purpose of this article is to explore both the legal difficulties and policy objections in using public nuisance against conduct which exposes others to the risk of contracting a harmful disease. Drawing on the judicial and legislative responses in Australia, Canada, New Zealand and the United Kingdom, I will identify the important issues of legal principle and public policy which must be addressed when considering the imposition of criminal liability in these circumstances.

This article examines the relation of risks and public policy through the lens of alcohol and crime. Alcohol thus lives a double-life as a fountain of celebration while also a wellspring of potentially serious harms. The issue of how risks might be managed much better is approached through considering three different arenas within the criminal law concluding that it is a crude mechanism for grappling with complex issues of criminal responsibility for any higher risks associated with becoming under the influence. (...) The article defends the use of nudges as an under explored area for public policy decision-making and proposes new policies based on them. (shrink)

On the 13th June 2014, the Centre for the Humanities and Health (CHH) at King’s College London hosted a one-day workshop on ‘Parentalism and Trust.’ This workshop was the sixth in a series of workshops whose aim is to provide a new model for high-quality open interdisciplinary engagement between medical professionals and philosophers. The term ‘Parentalism’ rather than paternalism is chosen and used throughout because of some of the derisory and unfortunate gender connotations associated with paternalism (and/or its counterpart ‘maternalism’). (...) Medical Parentalism is the position that unwanted interference with a patient’s choices and actions in order to protect and promote her best interests is morally justified. Whilst there are many problems with its justification and implementation, the workshop addressed how such interference depends on a trusting relationship between the doctor and patient, and the extent to which parentalist interferences might undermine this trust. (shrink)

In this paper I first argue that when answering the question of whether or not governments may restrict emigration, Brock and Blake are staking out positions not astronomically far from one another. Despite the ostensibly large philosophical gap between the two, both think that certain governments may restrict emigration when such restriction is agreed to in a morally binding contract. Secondly, both authors think that there are specific “circumstances” or “conditions” under which a contract that restricts emigration can be morally (...) binding. This second part of the paper will pose some questions that explore these various circumstances or conditions. The ultimate aim of the paper is to help point the debate in the right direction so as to further develop an answer to the question of whether or not governments may restrict emigration. (shrink)