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.

A dearth of clinical research involving children has resulted in off-licence and sometimes inappropriate medications being prescribed to the paediatric population. In this environment, recent years have seen the introduction of a raft of regulation aimed at increasing the involvement of children in clinical trials research and generating evidence-based medicinal preparations for their use. However, this regulation pays scant attention to the autonomy of competent minors. In particular, it makes no provision for the ability of competent minors to consent to (...) participate in medical research and is therefore at odds with best ethical practice. This article explores the tensions between law and ethics in relation to clinical research involving minors and concludes that greater respect should be given to the autonomy of those minors who are competent to decide for themselves. (shrink)

Machine generated contents note: Table of Cases xi -- Table of legislation xv -- Introduction: Medicine Men, Outlaws and Voluntary Euthanasia 1 -- 1. To Kill or not to Kill; is that the Euthanasia Question? 9 -- Introduction-Why Euthanasia? 9 -- Dead or alive? 16 -- Euthanasia as Homicide 25 -- Euthanasia as Death with Dignity 29 -- 2. Euthanasia and Clinically assisted Death: from Caring to Killing? 35 -- Introduction 35 -- The Indefinite Continuation of Palliative Treatment 38 -- (...) Withholding or Withdrawing Treatment 44 -- The Principle of Double Effect 54 -- Physician Assisted Suicide 60 -- Mercy Killing 64 -- Conclusions 66 -- 3. Consent to Treatment but Not to Death 69 -- Introduction-Why Consent? 69 -- Without Consent 70 -- Killing and Consent 73 -- Valid Consent, Freely Given? 74 -- Old Enough to Consent 80 -- Deciding for Others 82 -- Conclusions-A Consent Too Far? 93 -- 4. Autonomy, Self-determination and Self-destruction 95 -- Introduction-Autonomous Choices 95 -- Choosing to Die-Suicide and Autonomy 100 -- Suicidal Intentions 107 -- Autonomous Clinical Discretion 110 -- Deciding to Live or Die-Whose Decision? 112 -- 5. Living Wills and the Will to Die 115 -- Introduction 115 -- I Know My Will 118 -- This is My Will 121 -- I Will Decide 128 -- Will My Will be Done? 134 -- Where There's a Will 137 -- Conclusions 143 -- 6. Is Euthanasia a Dignified Death? 145 -- Introduction-Why Dignity? 145 -- Needing Dignity 146 -- Finding Dignity 149 -- Achieving Dignity in Dying 151 -- Dignifying Death 157 -- 7. Conclusions: Dignified Life, Dignified Death and Dignified Law 165 -- Select Bibliography 175 -- Index 183. (shrink)

In order for children to receive the best possible medical treatment, it is essential that research is conducted to discover safe and effective interventions and dosages. This article focuses on the legal and ethical implications of recruiting into health-care research minors who are not competent to consent. It considers the role played by best interests in obtaining valid parental consent for the participation of children in research, both at common law and under the Regulations that govern clinical trials of medicinal (...) products. In doing so it questions the legality of parental consent to children's involvement in research, and identifies some inconsistencies in parental understandings of best interests in relation to medical research and treatment. (shrink)

This commentary explores the background to, and implications of, the recently published Director of Public Prosecutions guidelines for prosecutors in respect of cases of encouraging or assisting suicide. It considers the extent of the provisions and questions the legitimacy of their focus on the compassionate motivation of the assistant, and the apparent prohibition on healthcare professionals providing such help. It concludes by suggesting that a permissive change in the law would provide better safeguards for those who seek assisted dying.

Leslie Burke challenged the GMC guidelines on withholding and withdrawing artificial nutrition and hydration because he wanted to ensure that food and fluids were not withdrawn from him at a time when he might still be cognisant. This article reviews the case and the judgments at first instance and in the Court of Appeal. In the interests of patient autonomy it argues that the patient is best placed to decide what is in her or his best interests and that the (...) first instance decision was an appropriate response to Mr Burke's challenge. (shrink)

The cases of Diane Pretty and Ms B. raise crucial issues about decision-making and autonomy at the end of life. Ms B. was permitted her wish to die rather than live permanently dependent upon a ventilator because her case was constructed as one about withholding consent to medical treatment, which every adult with capacity has a right to do. Mrs Pretty, however, sought active intervention to end her life. Requiring assistance to die, and claiming that this was her human right, (...) she sought an assurance that her husband would not be prosecuted if he helped her. Her claim was rejected and the assurance refused. The cases prompt questions about the nature of autonomy, the influence of others and the different way sin which medical and legal decisions are made. (shrink)