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Archive for the ‘Conferences’ Category

Honouring the Contributions of a Founder of Medical Law

In 2015, Conferences, Uncategorized on December 14, 2015 at 9:29 am

Prof. John Coggon

On Friday 4th December, Hazel Biggs, David Gurnham, and I attended a meeting arranged at the University of Manchester to honour the contribution that Margot Brazier has made to the field of Medical Law. It is hard to describe in full enough terms the impact that Margot has had on legal scholarship, understanding, and practice. And even if we limit ourselves to the major area of study that she has pioneered—medical law—it is hard to capture quite how much she has given.

Margot is the quintessential scholar. She excels in her research, as a teacher, and as a figure engaged in significant questions of public ethics and policy. Just consider the research interests of each of HEAL’s core members in the Law School—Hazel Biggs, John Coggon, David Gurnham, Caroline Jones, Natasha Hammond-Browning, Claire Lougarre, Remigius Nwabueze, and A.M. Viens. Not one of us works in a field to which Margot has not offered significant insights and understanding. To repeat a term already used, she is a true pioneer: as was recognised both on the day, and in a festschrift that has been published in her honour.

The conference was a fantastic tribute to Margot’s great work. Hazel was amongst those speaking, but all who attended were able to attest to how much we owe Margot. Lady Hale’s foreword to the festschrift, which was the basis of her speech at the conference, provides in duly flattering terms the essence of what it is that has led to Margot inspiring, encouraging, supporting, mentoring, and advising so many of us in the field. She is a fantastic scholar, whose work—and approach to life—is founded on an uncompromising and deep-seated humanity.

As a whole research centre, we at HEAL are delighted to report our participation in this landmark event, and to thank Margot more than wholeheartedly for having helped define this field of study: I am sure it is fair to say that at least I, if not others in the Centre, would not be here without Margot.

Final Summary Report for ESRC series on ‘Criminalizing of Disease Transmission’

In Conferences, funded research, Gratuitous self-promotion, Meetings on January 19, 2015 at 8:30 am

David Gurnham (HEAL and ICJR, University of Southampton) has recently completed an ESRC-funded series of seminars in collaboration with colleagues at the University of Manchester (Catherine Stanton and Hannah Quirk) focusing on the criminalization of disease transmission. Their final summary report is now completed and will be available via the HEAL and ICJR websites, and direct from this link: Criminalizing Contagion_summary_report_Nov_2014. The seminars, which took place at the Universities of Southampton and Manchester from January 2012 until September 2014 addressed a series of questions: how should the law treat a person who transmits a serious infection such as HIV, or exposes others to the risk of infection? For example, should such a person be treated as a criminal, in the same way as someone who injures another?

In this seminar series, we have tried to highlight and explore some of the most pressing implications that the deprivation of a person’s liberty in response to infectious disease transmission has for a number of professional and public organisations. While we did not identify any one view on criminalization, we heard and read strong criticism of the use of criminal sanctions in this context, as well as defences of criminal sanctions in some circumstances.

As well as academic scholars approaching the subject from criminal law and criminal justice, healthcare and ethics perspectives, the seminars establish a link with four key organizations, all of which are involved in one or more of relevant policy engagement, legal reform and clinical practice. These are Amnesty International, the British Association for Sexual Health and HIV (BASHH – an organization made up of professionals working in sexual health), the Crown Prosecution Service (CPS) and the Law Commission. With the exception of Amnesty, we have had representations from each of them, alongside participants across a range of other relevant organizations and institutions at the seminars.

A number of different sorts of publications have arisen from the seminars: academic papers presented at the seminar have been or will soon be published across a number of formats (special journal issues, a book of collected essays); article contributions by practicing medical and healthcare experts have been published in response to a call for papers in three British Medical Journal Group journals; papers have been published by David Gurnham and Catherine Stanton in response to the themes explored in the seminars. For full details of publications and paper presentations, see the Criminalizing Contagion_summary_report_Nov_2014.

How and why do we value scientific freedom?

In 2014, Conferences, Gratuitous self-promotion, Publications on April 7, 2014 at 12:54 pm

With teaching over, it’s good to have a bit of time for writing and going to conferences. I’ve just got back from a trip to Rome, where I attended the third meeting of the World Congress for Freedom of Scientific Research. The meeting is a key event hosted by the Luca Coscioni Association, which aims to eradicate undue bars to science and innovation. With Simona Giordano and Marco Cappato, I edited a book on Scientific Freedom following the first of these Congresses. As well as existing in hard copy, it is available here open access.

The Congress that just took place focused on the relationship between science and politics. In my own paper, I raised issues about the central place that the public interest should take in our analyses and evaluations of scientific freedom. This cuts against some of the received wisdoms amongst members of the scientific community, who are wary of the public interest (or in related literatures on the national interest). The wariness is born of concerns that the public interest will simply be given as a dogmatic, knock-down argument against good science, with no sound rationale behind it. Whilst we should be alive and responsive to such concerns, if we are to advance scientific programmes, we also need to be able to explain how these serve the public interest.

Scientific freedom is not just a ‘negative right’; a right to be left alone (and even in instances where it is, it can still impose positive claims and costs on the State and others). And really, advocates for scientific freedom are anyway asking governments not only to permit, but also to protect and indeed promote science. In doing this, we see important roles for law and regulation, providing both a shield, where defences are needed of scientific activity, and a stage, where publicity and education are needed. In my paper, I aimed to capture the reasons for this, and to explain that those in the scientific community need to understand why the public interest may at times legitimately constrain, as well as advance, science.

The event in its entirety was quite intense, with a great range of speakers and papers. Although it was built around a shared agenda, there was nevertheless a fascinating variety of perspectives. Furthermore, the span of insights afforded was astounding. Speakers included scientists and other academics, but also activists, politicians, people working in policy, journalists, and jurists. I left with a sense that many of the practical upshots of the meeting will arise as individual developments. ‘Science’ is vast and varied. But the general movement, and the added momentum that can be found when people with associated interests come together, will add to the power of such developments.

John Coggon

What is ‘proper medical treatment’?

In 2013, Conferences, Key Legal Concepts on September 18, 2013 at 7:52 am

It makes a big difference to the legal, social, and to many minds moral acceptability of interventions to know that they are—or are not—‘proper medical treatment’. In English medical law, even for people who aren’t found to lack decision-making capacity, consent alone is insufficient to make an intervention lawful; it has, according to some external standard, to constitute treatment that serves a person’s interests. But where does medicine find its legitimacy? What about a medical act attracts legal protection when a qualitatively identical act undertaken by a non-medic would not be deemed to serve someone’s interests, and be criminal? How far can ‘medicalisation’ legitimise what would otherwise be beyond the pale; assisted dying, cosmetic procedures, and so on?

In an impressive, wide-ranging series of discussions at a conference I attended last week, some of the key questions were raised and explored about how we understand ‘proper medical treatment’, and challenges were made to the reverence that we might offer it. The meeting, organised by Sara Fovarague and Alex Mullock, was built on the theme “Transforming wrong(s) into right(s): The power of ‘proper medical treatment’”. The legitimacy—or as Margot Brazier suggested on Thursday perhaps the magic—of medicine, forestalling prosecutions for what would on their face be criminal acts, is found in the legal concept of the ‘medical exception’. But to be proper, it is insufficient simply that treatment is given by a doctor, or even that its provision is recognised and endorsed in the professional opinion of a number of doctors. Coming to a clear understanding of ‘proper’ is as hard as coming to a clear understanding of ‘medical’. Yet these terms have crucial importance in practice.

I was lucky enough to be a discussant on a panel with speakers Julian Sheather and Cam Donaldson, who respectively interrogated the theme from political and economic perspectives. Julian demonstrated how political ends can be achieved through medicalisation, even in the face of serious objections from the profession itself, whilst Cam provoked interesting questions about how a health economist might assess the idea of ‘proper’ in proper medical treatment. Cam also made clear how important it is to include a health economics perspective in these ethical and legal debates.

Reflecting on the ideas from a legal perspective, I would question—regardless of whether we are convinced by the moral weight of designating something ‘proper medical treatment’—how much conceptual grip we can get on the idea of medical treatment by looking at what judges, practitioners, and policy-makers have to say. If the NHS is to afford what amounts to a right to healthcare, and if we are to recognise the importance of healthcare practitioners’ expertise, it seems inevitable—and right—that we should conceive of robust central cases of medical treatment. But at the fringes, there will be fuzzy, contestable claims about whether something should be seen as proper treatment or not. In those instances, we may look to decided cases and existing regulations, but the bases of their rationales will be wide and varied: for example, tax law cases based on European Union law; individual claims for intervention based on the European Convention on Human Rights.

A strong degree of coherence is needed if we are to enjoy a healthcare system whose legal and ethical rationale is not arbitrary. Yet too constraining a rationale will stifle innovation, and damage protections of plural values that healthcare law protects. A project aimed at understanding ‘proper medical treatment’ is an important one. At its end, I wonder if an exhaustive definition will necessarily be the best one.

John Coggon, Southampton Law School.