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Law Notes Medical Law Notes

Applying The Law To Difficult Cases

Updated Applying The Law To Difficult Cases Notes

Medical Law Notes

Medical Law

Approximately 1067 pages

Medical Law notes fully updated for recent exams at Oxford and Cambridge. These notes cover all the LLB medical law cases and so are perfect for anyone doing an LLB in the UK or a great supplement for those doing LLBs abroad, whether that be in Ireland, Hong Kong or Malaysia (University of London).

These were the best Medical Law notes the director of Oxbridge Notes (an Oxford law graduate) could find after combing through forty-eight LLB samples from outstanding law students with the highest...

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Applying the Law to difficult cases

The administration of pain-relieving drugs

  • The general principles

    • If D gives P drugs knowing and in order to kill P, and death results, then this can be murder

      • Bland

        • Lord Goff:

          • It is not lawful for a doctor to administer a drug to his patient to bring about his death

            • Even if that course of treatment is prompted by a humanitarian desire to end suffering, however great that might be.

    • How about where D gives P drugs knowing they will likely kill P, but with the intention to relieve P’s pain, not to kill

      • Bland

        • Lord Goff

          • It is an established rule that a doctor may, when caring a for P who is dying from a terminal disease

            • lawfully administer painkilling drugs despite that fact that he knows the incidental effect of that application will be to abbreviate the patient’s life

          • Such a decision may properly be made as part of the care of the living patient and his best interests

            • And on this basis, the treatment is lawful.

      • R v Cox: D injected a lethal amount of potassium chloride in order to kill P who was suffering from intense pain. P had repeatedly asked D to kill him, and eventually D relented. The drug itself only shortened P’s life, and otherwise had no analgesic value so could not be classed as pain relief.

        • Foster: He was only charged with attempted murder, which was a tactical move by the prosecution,

          • as juries will very often acquit in full murder prosecutions owing to the mandatory life sentence.

Persistent vegetative state

  • Definition

    • PVS patients cannot be kept alive unaided and without the use of a life support machine

      • However, they are not always completely immobile, and can retain some auditory or visual stimuli – although the amount depends on the degree suffered

    • They cannot eat or drink unaided, and while it can never be certain that the condition is irrecoverable

      • Most will not recover and only stay alive until some natural disease gets them, or treatment is withdrawn.

  • The Law

    • Doctors must comply with any advance directives issued by the patient which state he does not want any life-sustaining treatment

      • Or else the test is whether it is in the best interests of P to require the treatment to be offered

      • Judicial permission is normally needed before hydration and nutrition are withdrawn from a patient in a PVS.

    • Airedale NHS Trust v Bland [1993]: B crushed on terraces of Hillsborough, in a persistent vegetative state. He went on for a number of years, and his family wished to withdraw treatment believing B had died on the Terraces.

    • An NHS Trust v J

      • Sir Mark Potter:

        • Although P was in PVS, a new drug offers a slim chance of recovery

          • Therefore, P should be treated with this drug first before the withdrawal of treatment is permitted

            • Even though both the family and doctors support a withdrawal of treatment.

  • Can this law apply beyond PVS cases?

    • BMA Guidance 2007: Withdrawing Life-Prolonging Medical Treatment:

      • Diagnostic guidelines are not statutory provisions, and a precise label may not be important

        • The court’s concern is whether there is any awareness whatsoever or any possibility of change

        • There has as yet been no decided case dealing the discontinuance of artificial feeding and hydration for an adult patient with any (however minimal) self awareness.

Severely disabled patients

  • Adults

    • Arguably the situation is worse for those not in PVS, but having some awareness of their condition

    • The MCA 2005 governs these situations, and the key question, absence any advance directives and capacity to decide/communicate = what is in their best interests?

      • Killing a person not permitted

      • How about withdrawing treatment?

        • Re R (Adult: Mental Treatment)

          • Taylor J

            • The...

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