1
Law and Medicine
Topic 1: Medical Ethics............................................................................................................1
Topic 1: Medical Ethics...................................................................................................................1
Lecture 1: Medical Ethics...............................................................................................................1
Lecture 1: Medical Ethics.........................................................................................................1
Topic 2: Consent.......................................................................................................................8
Topic 2: Consent..............................................................................................................................8
Lecture 3: Consent Part 2.............................................................................................................14
Lecture 3: Consent Part 2.......................................................................................................14
Lecture 4: Consent Part 3.............................................................................................................27
Lecture 4: Consent Part 3.......................................................................................................27
Lecture 5: Consent Part 4.............................................................................................................32
Lecture 5: Consent Part 4.......................................................................................................32
Topic 3: End of life decision-making.....................................................................................36
Topic 3: End of life decision-making............................................................................................36
Topic 4: Transplantation........................................................................................................82
Topic 4: Transplantation..............................................................................................................82
Topic 5: Abortion..................................................................................................................111
Topic 5: Abortion........................................................................................................................111
Art. 2(1) ECHR:-....................................................................................................................................124
Topic 6: Reproductive Medicine...........................................................................................133
Topic 6: Reproductive Medicine................................................................................................133
Reproductive Medicine Lecture 1: The Regulatory System.......................................................................133
Examination Issues......................................................................................................................162
Examination Issues...............................................................................................................162
Topic 1: Medical Ethics
Lecture 1: Medical Ethics
Lecture 1 will introduce the module and provide an overview of medical ethics. Since this is
a module on ethically controversial features of medical practice, ethics is relevant to all of
this module’s topics.
The reading for medical ethics is either ch 1 of Shaun Pattinson (2020) Medical Law and
Ethics (6th edn) (Sweet & Maxwell) or ch 1 of Emily Jackson (2022) Medical Law: Text,
Cases, and Materials (6th edn) (OUP).
Topic outline
, 2
(1) medical ethics (controversial topics/how to answer
(2) consent to medical interventions
(3) end of life decisions
(4) Transplantation (often coincides with consent)
(5) abortion (2)
(6) reproductive medicine (3)
(7) two revision lectures – go through the problem question in the module handbook
and second where he goes through those essay questions
Reading : take all out of the library at some point and read!
• Shaun Pattinson, Medical Law and Ethics (6th edn, 2020)
Alternatives:
Margaret Brazier & Emma Cave, Medicine, Patients and the Law (7th edn, 2023)
Emily Jackson, Medical Law: Text, Cases and Materials (6th edn, 2022) – best case
book in the market – available electronically in the library and law trove
Reading for this lecture:
• Pattinson 2020, ch 1 or Jackson 2022, ch 1
Do not confuse medical ethics with professional ethics
• Professional bodies, such as the General Medical Council and the Nursing and Midwifery
Council, offer advice on professional conduct to healthcare professionals. But this guidance
does not foreclose questions on what is ethically defensible.
Ethical advice (professional bodies – useful, informative)
Medical law – whether it is medically defensible (not closed by the fact that they merely
come to a view)
Only understand medical law if you know medical ethics – intervened with debate in this
area – not always clear (debates about what laws and the alternatives which could be taken
to that law, understand own views – place own ethical views within a framework so we
understand how they fit/don’t fit with other views).
Different words can be used to describe the same concept – font focus on word focus on the
meanings.
What is an ethical or moral issue?
• Ethics and morality are used as synonyms in this module for positions on what is
permissible/what duties are owed to others.
Same thing or slightly different – we will be using them as synonyms.
, 3
Right/wrong – permissible/impermissible – duties to act in the interests of persons other
than ourselves. Issue about the duties we owe to others to act in their interests.
Slide 4 – INPUT – need to ask for PowerPoints
Moral relativism v Moral Objectivism
Moral relativism (RELATIVE) (d), sometimes called moral subjectivism, is the position
holding that basic moral views cannot be true or rational (ie they are on a par with
regard to their truth or rationality). This means that all moral values are ultimately
just a matter of opinion. It is not to be confused with the empirical statement that
different individuals have different views on ethical issues.
It is a simple preference/moral objectives
Relative – basic moral values cannot be true or rational. You can still reason
from values but the values themselves are assumed, givens - something that
you just believe rather than prove is true or rational.
According to this view – not rationally distinguishing between moral views –
e.g. choice between Hitler or Gandhi is just a matter of opinion
Not implied by the f act there are different moral views in the world.
There might be a resolution of an objective answer if
Imperial fact of a controversial matter – ask opinions = Doesn’t mean all
those views are on par with morality.
“there are no rights or wrongs”
Moral objectivism (OBJECTIVE/UNIVERSAL), sometimes called moral universalism, is
the position holding that basic moral views can be true or rational. It is not to be
confused with the claim that moral questions are easy to answer or not disputed.
True or rational (two different views treating it as one).
Not the statement that we know the answers to every moral question (that
would be moral omniscience)
Disagreement doesn’t imply moral relativism and the fact we don’t know a
question on morality doesn’t imply a rejection of moral relativism.
No happy medium – one or other. Denial of each other.
Most critics sympathise with a moral of moral objectivism – don’t thing something that is
‘wrong’ is just a matter of opinion.
Criteria for moral permissibility: how do we decide what is right?
(1) Utilitarian theories
(2) Duty-based theories
(3) Rights-based theories
(4) Virtue ethics
(5) Mixed theories
5 theoretical positions
There are 5 groups of criteria on how, if morality is to have any objective or universal
features, we are to decide what is morally permissible.
, 4
(1) Utilitarianism (a)
* The view that we must seek the best utility balance. Utilitarians typically seek to maximise
pleasure over pain or maximise the satisfaction of preferences.
Supreme principle of morality
Seeks the best balance of utility over disutility. What’s good is what maximises utility
(overall balance)
Typically, we should seek to maximise overall pleasure over pain (classical or
hedonistic utilitarianism) or maximise overall preference satisfaction (preference
utilitarianism)
To count at all you must be sentient (The only means that can count are those that
are sentient – ability to feel pain or pleasure). Maximise pleasure over pain or
maximise preferences it requires you to be able to feel pain?
View – very egalitarian – every individual counts for one and no more than one. No
one counts for more than one, but the interests/preferences of different individuals
can be added together - utilitarian would add up the study group/group impacted
say 1,000 and prioritise the group over the interests of one individual.
Straightforward to apply. Look at consequences and choose the one which
maximises utility.
Welfare is the shorthand for utility
Examples
Value statement: (a) Medicine should maximise overall welfare
Jeremy Bentham: “The greatest happiness of the greatest number is the foundation
of morals and legislation” – maximise pleasure over pain.
Peter Singer (was a preference utilitarian and now a hedonistic utilitarian) using this
approach to defend abortion and end of life decisions – voluntary decisions –
maximise utility.
Other examples: Katarzyna de Lazari-Radez, Jonathan Glover, John Harris, Julian
Savulescu, Henry Sidgwick
(2) Duty-based theories (b)
The view that we must protect the moral interests of individuals. Those interests are
objective, so do not always track what the patient wants – duties to protect the
important interests of individuals.
Recipients of a duty are not automatically entitled to waive its benefit (ie cannot
consent to all harms)
Most important interests are not determined by your will (CRUCIAL) life is
more important than your will.
Two types – one says from the point of conception and the other at a later point –
usually when you can think for yourself.
All humans are equal (either from conception or from a later point)
The interests of different individuals cannot be added together (disagree with above)
– save life of one or thousand – cannot add those interests. Duty is to protect life.
Law and Medicine
Topic 1: Medical Ethics............................................................................................................1
Topic 1: Medical Ethics...................................................................................................................1
Lecture 1: Medical Ethics...............................................................................................................1
Lecture 1: Medical Ethics.........................................................................................................1
Topic 2: Consent.......................................................................................................................8
Topic 2: Consent..............................................................................................................................8
Lecture 3: Consent Part 2.............................................................................................................14
Lecture 3: Consent Part 2.......................................................................................................14
Lecture 4: Consent Part 3.............................................................................................................27
Lecture 4: Consent Part 3.......................................................................................................27
Lecture 5: Consent Part 4.............................................................................................................32
Lecture 5: Consent Part 4.......................................................................................................32
Topic 3: End of life decision-making.....................................................................................36
Topic 3: End of life decision-making............................................................................................36
Topic 4: Transplantation........................................................................................................82
Topic 4: Transplantation..............................................................................................................82
Topic 5: Abortion..................................................................................................................111
Topic 5: Abortion........................................................................................................................111
Art. 2(1) ECHR:-....................................................................................................................................124
Topic 6: Reproductive Medicine...........................................................................................133
Topic 6: Reproductive Medicine................................................................................................133
Reproductive Medicine Lecture 1: The Regulatory System.......................................................................133
Examination Issues......................................................................................................................162
Examination Issues...............................................................................................................162
Topic 1: Medical Ethics
Lecture 1: Medical Ethics
Lecture 1 will introduce the module and provide an overview of medical ethics. Since this is
a module on ethically controversial features of medical practice, ethics is relevant to all of
this module’s topics.
The reading for medical ethics is either ch 1 of Shaun Pattinson (2020) Medical Law and
Ethics (6th edn) (Sweet & Maxwell) or ch 1 of Emily Jackson (2022) Medical Law: Text,
Cases, and Materials (6th edn) (OUP).
Topic outline
, 2
(1) medical ethics (controversial topics/how to answer
(2) consent to medical interventions
(3) end of life decisions
(4) Transplantation (often coincides with consent)
(5) abortion (2)
(6) reproductive medicine (3)
(7) two revision lectures – go through the problem question in the module handbook
and second where he goes through those essay questions
Reading : take all out of the library at some point and read!
• Shaun Pattinson, Medical Law and Ethics (6th edn, 2020)
Alternatives:
Margaret Brazier & Emma Cave, Medicine, Patients and the Law (7th edn, 2023)
Emily Jackson, Medical Law: Text, Cases and Materials (6th edn, 2022) – best case
book in the market – available electronically in the library and law trove
Reading for this lecture:
• Pattinson 2020, ch 1 or Jackson 2022, ch 1
Do not confuse medical ethics with professional ethics
• Professional bodies, such as the General Medical Council and the Nursing and Midwifery
Council, offer advice on professional conduct to healthcare professionals. But this guidance
does not foreclose questions on what is ethically defensible.
Ethical advice (professional bodies – useful, informative)
Medical law – whether it is medically defensible (not closed by the fact that they merely
come to a view)
Only understand medical law if you know medical ethics – intervened with debate in this
area – not always clear (debates about what laws and the alternatives which could be taken
to that law, understand own views – place own ethical views within a framework so we
understand how they fit/don’t fit with other views).
Different words can be used to describe the same concept – font focus on word focus on the
meanings.
What is an ethical or moral issue?
• Ethics and morality are used as synonyms in this module for positions on what is
permissible/what duties are owed to others.
Same thing or slightly different – we will be using them as synonyms.
, 3
Right/wrong – permissible/impermissible – duties to act in the interests of persons other
than ourselves. Issue about the duties we owe to others to act in their interests.
Slide 4 – INPUT – need to ask for PowerPoints
Moral relativism v Moral Objectivism
Moral relativism (RELATIVE) (d), sometimes called moral subjectivism, is the position
holding that basic moral views cannot be true or rational (ie they are on a par with
regard to their truth or rationality). This means that all moral values are ultimately
just a matter of opinion. It is not to be confused with the empirical statement that
different individuals have different views on ethical issues.
It is a simple preference/moral objectives
Relative – basic moral values cannot be true or rational. You can still reason
from values but the values themselves are assumed, givens - something that
you just believe rather than prove is true or rational.
According to this view – not rationally distinguishing between moral views –
e.g. choice between Hitler or Gandhi is just a matter of opinion
Not implied by the f act there are different moral views in the world.
There might be a resolution of an objective answer if
Imperial fact of a controversial matter – ask opinions = Doesn’t mean all
those views are on par with morality.
“there are no rights or wrongs”
Moral objectivism (OBJECTIVE/UNIVERSAL), sometimes called moral universalism, is
the position holding that basic moral views can be true or rational. It is not to be
confused with the claim that moral questions are easy to answer or not disputed.
True or rational (two different views treating it as one).
Not the statement that we know the answers to every moral question (that
would be moral omniscience)
Disagreement doesn’t imply moral relativism and the fact we don’t know a
question on morality doesn’t imply a rejection of moral relativism.
No happy medium – one or other. Denial of each other.
Most critics sympathise with a moral of moral objectivism – don’t thing something that is
‘wrong’ is just a matter of opinion.
Criteria for moral permissibility: how do we decide what is right?
(1) Utilitarian theories
(2) Duty-based theories
(3) Rights-based theories
(4) Virtue ethics
(5) Mixed theories
5 theoretical positions
There are 5 groups of criteria on how, if morality is to have any objective or universal
features, we are to decide what is morally permissible.
, 4
(1) Utilitarianism (a)
* The view that we must seek the best utility balance. Utilitarians typically seek to maximise
pleasure over pain or maximise the satisfaction of preferences.
Supreme principle of morality
Seeks the best balance of utility over disutility. What’s good is what maximises utility
(overall balance)
Typically, we should seek to maximise overall pleasure over pain (classical or
hedonistic utilitarianism) or maximise overall preference satisfaction (preference
utilitarianism)
To count at all you must be sentient (The only means that can count are those that
are sentient – ability to feel pain or pleasure). Maximise pleasure over pain or
maximise preferences it requires you to be able to feel pain?
View – very egalitarian – every individual counts for one and no more than one. No
one counts for more than one, but the interests/preferences of different individuals
can be added together - utilitarian would add up the study group/group impacted
say 1,000 and prioritise the group over the interests of one individual.
Straightforward to apply. Look at consequences and choose the one which
maximises utility.
Welfare is the shorthand for utility
Examples
Value statement: (a) Medicine should maximise overall welfare
Jeremy Bentham: “The greatest happiness of the greatest number is the foundation
of morals and legislation” – maximise pleasure over pain.
Peter Singer (was a preference utilitarian and now a hedonistic utilitarian) using this
approach to defend abortion and end of life decisions – voluntary decisions –
maximise utility.
Other examples: Katarzyna de Lazari-Radez, Jonathan Glover, John Harris, Julian
Savulescu, Henry Sidgwick
(2) Duty-based theories (b)
The view that we must protect the moral interests of individuals. Those interests are
objective, so do not always track what the patient wants – duties to protect the
important interests of individuals.
Recipients of a duty are not automatically entitled to waive its benefit (ie cannot
consent to all harms)
Most important interests are not determined by your will (CRUCIAL) life is
more important than your will.
Two types – one says from the point of conception and the other at a later point –
usually when you can think for yourself.
All humans are equal (either from conception or from a later point)
The interests of different individuals cannot be added together (disagree with above)
– save life of one or thousand – cannot add those interests. Duty is to protect life.
