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Special Issues

The Mental Capacity Act 2005—Ten Years On

This special issue brings together a selection of articles that critically reflect on the ten years that has passed since the Mental Capacity Act 2005 (‘MCA’) received royal assent. The MCA, described as a ‘visionary’ piece of legislation, sought, wherever possible, to empower people to make decisions for themselves and to protect the vulnerable, whilst also engineering a cultural shift in attitudes to incapacity and the treatment of those with impaired decision making. The articles in this special issue reflect upon the statute, its implementation, and undertake judicial analysis of its application.

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Conscience and Proper Medical Treatment

This special issue brings together a selection of articles that critically assess the concepts of ‘proper medical treatment’ and ‘conscience’ and the interplay between them. They contribute to a growing and important body of literature which assesses medical professionals’ attitudes towards particular medical practices. Particularly controversial practices, such as abortion and end of life decision-making, are often viewed as challenging the boundaries of proper medical practice. Indeed, it is often in these areas that claims of conscience come to the fore. Conscientious provision is sometimes used to describe the provision of treatments whose legality is ambiguous, while conscientious refusal is often claimed as a protection for refusal to provide treatments whose legality is clear. The articles in this special issue use these sites of controversy as a way of igniting analysis and drawing the themes in the issue together. They consider medical practice in relation to abortion, and consider how conscience and the concept of proper medical treatment can and should operate more broadly and in other areas of health care. The articles advance understandings of how particular practices come to be accepted and others remain at the margins, and challenge and expand on the role and function of conscience within proper medical treatment.

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Markets and Vulnerable Patients: Health Law After the 2012 Act

Utilising the UK's new Health and Social Care Act as a starting point from which to assess the post-2012 health environment, this special edition brings together an eclectic mix of traditional medical law specialists with those from an increasing number of cognate disciplines. Crucially the papers in this edition contribute to existing health law discourses by considering the dynamic between health as a social good and as a marketable commodity and the impact of that dynamic on vulnerable patients. Questions are inherently raised about whether the 2012 Act goes too far in conceiving of health as a competitive opportunity and whether it is premised on an archaic understanding of healthcare providers. Comparative analyses facilitate consideration of how other countries' have reformed their health services and how the UK, as an EU Member State, is bound by overarching European Union Law. In addition to the regulatory landscape, the ethical dimension is considered in the context of vulnerable patients and within a broader understanding of vulnerability which extends to include everyone: who may participate in trials; who will take medicine; and who inevitably will age. Finally, the impact of the 2012 Act on traditional medical law areas such as clinical negligence is considered to round off an understanding of healthcare as an issue which has much to learn from other disciplines.

Regulatory 'Desirables' for New Health Technologies

This special issue examines the relationship between health, technology and regulation. The papers analyse key aspects of this relationship including designing regulation to manage risk and uncertainty, the tensions between regulation and innovation, and techniques for enhancing regulatory legitimacy. Most importantly, the issue considers whether there is an emerging consensus about what is necessary or desirable in regulating new health technologies.

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Across the Spectrum of Medical Law: A Special Issue in Honour of Margaret Brazier

The first issue of 20th volume of the Medical Law Review is a special issue in honour of Professor Margaret Brazier to mark both her retirement from her role as the Editor-in-Chief in 2010 and the twentieth anniversary of the journal. In recognition of Professor Brazier’s invaluable contribution to the field of health care law and her seven year editorship of the Medical Law Review, the papers in this issue consider some of her published pieces, exploring the wide influence of her work and the ways in which her arguments and ideas have been taken forward. 

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Mental Health Law in Motion - Confronting New Challenges in the Modern Psychiatric Landscape

"Mental health provision has been the focus of intense political and policy debate for a considerable time; with law reform finally arriving in the shape of an amendment act - the Mental Health Act 2007. To what extent does this change to the regulatory framework, alongside vociferous discussions, vacillating public opinion and extensive media exposure, respond to the inherent tensions that have always featured, and indeed, have at times beleaguered mental health care? This special issue of the Medical Law Review presents several papers which explore varied aspects of contemporary mental health law, and taken together, offer a collection of insightful and critical reflections on the new and continuing challenges facing psychiatry." - Dr. Nicola Glover-Thomas.

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Legal challenges and new horizons for medicalised death and dying

2010 has been an eventful year in the life of the debate about assisted dying. In February, the Director of Public Prosecutions issued guidelines outlining the public policy factors that should be considered when determining whether to prosecute a person for assisting the suicide of another.In the same month, the Suicide Act 1961 was amended by the Coroners and Justice Act 2009, which reframed the offences relating to helping another person to end their life. Now, rather than aiding and abetting, counselling or procuring the suicide of another', a defendant will be liable if she intentionally does an act capable of encouraging or assisting the suicide or attempted suicide of another person. Soon after the General Medical Council (GMC) published new guidance on medical decision-making at the end of life, Treatment and Care Towards the End of Life. Applicable explicitly within the existing legal framework, these guidelines locate the patient at the centre of end-of-life decision-making and operate according to presumptions in favour of prolonging life and that each individual patient has the capacity to decide for herself. At the back end of the year, virtually as this editorial was going to press, a new ‘pressure' group was launched. Healthcare Professionals for Change supports the wider campaign aims of that favour greater patient choice at the end of life based on the conviction that people ought not have to suffer against their wishes and should therefore, within appropriate safeguards, be able to choose an assisted death.And throughout the year, news reports featuring assisted dying cases and debates have appeared regularly in the media.

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