ANH, Sterilisation, IVF and Patient Confidentiality within English Medical Law

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Image: ‘Sterile Processing’ by Khara Oxier

ANH, Sterilisation, IVF and Patient Confidentiality within English Medical Law

The Case Law Compendium Q&A

Books

Why did you write The Case Law Compendium?

I wrote the book for a number of reasons, but if pushed for a single motivation it would be to enable law students to navigate and hopefully excel at studying for their degrees. I could expand upon this, but that’s the shortest answer I can give you. In fact, the idea traces back to ‘The Black Letter’, which I created to keep myself busy after graduating with my LL.B (Hons) Law degree.

Essentially I set out to read and write about a number of cases I had touched upon while at university, expecting nothing more from the experience other than to stimulate my mind, and put my thoughts out there for those who might stumble across this website.

However, something quite unexpected happened.

What was this unexpected event?

In the months following the launch of The Black Letter (Black Letter Publishing), my visitor statistics were much higher than anticipated, however, it was the diversity of visitors that really surprised me. After calculating the numbers, I realised that people from over 110 countries had visited the website to read my case studies, and in fact this trend has continued to grow since then.

This indicated that not only was my writing appealing, it was reaching students all over of the globe, and this international outreach really excited me. It was then that my wife explained how a book would the perfect way to genuinely help law students, especially given that I couldn’t be there in person to help them understand the complexities of case law.

So which kind of student was it designed to help?

Quite literally all law students everywhere. And while I realise that each country has its own laws and jurisdictions, there is clear evidence that English law leads the way in this field, therefore the potential to assist overseas students is enormous. I cannot stress enough that The Case Law Compendium is much more than a book, it’s a study support resource unlike any law course book I have ever read, and I can say that with confidence, because had I found anything remotely similar to this whilst at university, I would have purchased it without a moment’s hesitation.

What make this book so special?

A number of things make The Case Law Compendium special, but to summarise it best, I would say that the book immediately closes the gap between the subject, the university and the student. And because law is built upon cases, undergraduates essentially have to quickly digest and appreciate why those cases are applied, relied upon, examined and used as precedent, and why the judges consult them when advancing laws or reaching decisions that the casual reader might not understand.

Institutionally speaking, most universities work to tightly scheduled timetables, and thus lectures are often overwhelming and confusing, largely because there just isn’t the time to explore case facets and themes.

However, by having a copy of The Case Law Compendium at the start of their course, every student can instantly refer to the cases discussed and thereby recognise the essence of the matter, the positions adopted by the courts, judges and litigating parties, without surrendering to hours of laboured reading in order to keep up with the strict course requirements.

Though perhaps the most invaluable aspect of this book is that it can be purchased and read literally months ahead of the required modules, thus preparing the students for the lectures, coursework and discussions ahead.

Likewise, by reading the additional modules in this particular publication, students can choose at least two of their selective modules with confidence. It’s also important to note that many family law cases will inevitably encroach on child law cases, again helping them with optional module selection.

From personal experience, property (land) and European law were the two most complex, challenging and often unnerving of the modules, even to the point that teaching the subject proved hard and painful to endure, largely because many cases are frequently layered, overlapping and therefore easily misunderstood. Yet by using The Case Law Compendium, the challenges are instantly reduced and reader knowledge is increased in a way that underpins the university curriculum.

Having spent many hours writing this invaluable book, I cannot overemphasise just how critical The Case Law Compendium is to all law students, especially those studying abroad, and it’s equally vital to remember that having stripped away all the superfluous material, keeping only that which will impact and explain exactly what happened and why, this is an asset not to be overlooked, particularly as English court transcripts are frequently, if not always, unforgiving to traverse, and so command absolute focus should the translation be correct.

So it makes the seemingly impossible, possible?

Yes. No matter how many ways you approach it, The Case Law Compendium defies traditional learning, because it marries the exactness of legal knowledge with the vulnerability of an uninformed reader, thereby producing something fresh and stimulating, a benefit unseen before in this complex and specialised field.

In fact, this book would take anybody remotely interested in law, and transform them into somebody able to now see inside the subject in a way that transcends convention, and yet enables them to respect and embrace the process of law in a totally different way.

By way of example, I recently practiced this approach with a Spanish acquaintance, unfamiliar with law, and yet after explaining a case that was connected to her country, she completely understood it, much to her surprise and my delight! In fact I have had quick success with everyone that I’ve tried this with, even explaining constitutional and European law to grandmothers in their seventies!

Because of this, I am supremely confident that once opened and digested, the readers will revel in their new found insight, while law students will keep the book firmly nestled inside their backpacks as their degrees unfold.

Who else can benefit from The Case Law Compendium?

Law lecturers, solicitors, postgraduates, professors, in fact anybody with a passing interest in law and the cases that help shape it.

Lecturers can refer to it to brush up on legislation and case discussions, they can even use it to copy key citations for presentations, in order to help explain the matters without taking up precious student time.

Solicitors can use it to remind themselves of key cases that might be useful when in court, and take advantage of the best citations when reaching out to the wisdom of the judges.

Postgraduates can use it to refer to cases that might be relevant for thesis or assignment arguments, or again, as a quick refresher of that which they would have already learned.

Professors, much like lecturers, can always rely upon the expeditious breakdown of case material and thematic content to help illustrate how laws have been influenced and outcomes altered, or even as a stimulating read on occasions where they feel compelled to remember how laws function.

Lay readers can simply delve into all the major topics without committing to a degree course, hopefully going on to study the subject in greater detail with increased confidence, or knowing it’s not the subject for them, while whatever the outcome, everybody wins.

Will it ever be sold in eBook format?

Having looked at the practicalities of this, I am sorry to say this is not an option right now. Those reasons stem from the fact that unlike fiction ‘novels’, the layout of the book requires the reader to note the citation references when reading and referring to it, which is not an option for Kindle devices and other associated electronic readers, besides, there is nothing like having a printed book beside you when working, as I can qualify, having proof read the book myself, and also having used it to quickly refer to court details etc. during the writing of this debut publication!

The Key Citations? What can you tell us about this aspect of the book?

One of the prerequisites of written legal text is that the student must include judgment citations relevant to the argument or theme discussed. This is a process that can require hours of laboured reading in order to find the most powerful statement relating to the case in hand. For those new to law, this is a huge challenge in itself, and so ultimately the only way to find these quotes, is from reading the case transcripts, documents that can run from ten to literally hundreds of pages, particularly in appeal cases, where there will be a number of judges commenting, as opposed to one in preliminary hearings.

In European law, there are also the opinions of both the Advocate-Generals and the Courts, again requiring valuable time in order to find the best, most relevant and impactive quotes possible.

By having personally analysed all 150+ cases during the preparation of the book, I have selected only the most relevant quotes before including them at the conclusion of the case studies.

In some instances, there are only one or two, while in others there are many more, a factor solely dependant on the judges themselves, who, when reading the material and organising their verdicts, offer knowledge that is purposeful to the matter.

This aspect of the book is quite simply essential, not only because the citations are there to both read and use, but because they have been fully OSCOLA referenced, thereby easily inserted into coursework without the need to find out the exact page number, judge name, court, and hearing date. This is yet another time-saving feature that everybody can benefit from, including undergraduates through to professors of law, while in the former example, academic grades are naturally reliant upon accurate referencing when impressing the markers.

So that’s three unique selling points rolled into one!

Yes it is, but the book goes far beyond that, it inspires the reader, opens the subject up and allows for everybody to discuss what it really means to go to court, or to apply law in our everyday world, even giving insight into how matters end up in front of judges, how institutions operate, governments function, criminals try to avoid punishment and small accidents become huge lawsuits.

What would you like to say as a closing statement?

I would close by saying to anybody remotely curious about the various laws of both England and Europe, and especially those about to begin their law degrees, that ‘The Case Law Compendium’ is quite simply the only purchase they will need to make outside of the core text books required by the universities, and while it will certainly provide buyers many hours of stimulating and enlightening reading, it will also serve as a tool that can be used again and again as their legal knowledge increases.

This alone makes The Case Law Compendium the best law study resource available anywhere in the world today, which is perfect, as it is live on most Amazon sites and ready for shipping to any country.

The book is also being actively marketed to literally thousands of leading bricks-and-mortar retailers, university libraries and online bookshops around the globe, so even if you don’t want to shop online, you can simply walk in and pick a copy up, borrow it from your campus library, or just order it through a book store.

The world’s No.1 case law study support resource has arrived!

Books

 

The Case Law Compendium: English & European Law
The Case Law Compendium: English & European Law by Neil Egan-Ronayne © 2017

 

The rapid international appeal of The Black Letter has led to the creation and  publication of the ‘The Case Law Compendium: English & European Law’ which will provide students everywhere with:

  • 150+ English leading case law studies
  • Covering Constitutional & Administrative Law, Contract Law, Criminal Law, Equity & Trust Law, European Law, Family Law, Medical Law, Property (Land) Law and Tort Law fields
  • Complex leading cases distilled into simplified and easily digestible text
  • Each case study includes Fully OSCOLA referenced hand-selected citations for immediate use in coursework

What does this mean to me?

What this means is that by personally analysing thousands of transcript pages, all the hard work of reading, understanding and translating the minds of the judges and courts is something you can finally say goodbye to. Each case also includes hand-selected and fully OSCOLA referenced citations that can be quickly inserted into written coursework (or moot skeleton arguments) without you having to hunt for them.

So now by simply having a copy of the ‘The Case Law Compendium’ close to hand you will be able to effectively engage in tutorial debates, improve your essay writing abilities, and expedite your knowledge of a multitude of legal fields without the pain of decoding the legislation and application of jurisprudence.

So when is it available?

It is available now through most Amazon sites, Waterstones and Barnes & Noble, and thanks to the brilliance of Print on Demand technology it will always be ready for worldwide shipping in just a few clicks.

I can only emphasise just how invaluable this book will become to you as your law  course progresses, and you’ll be surprised at just how fast you learn the cases and how your confidence grows when discussing their finer points. I am supremely confident that you will also find yourself returning to the book when studying both for insight and refreshment of knowledge, and I quietly hope you will be equally excited whenever you turn to this unprecedented resource.

Please remember that it was you the worldwide readers, that inspired this book, so you owe it to yourselves to buy it (and use the hell out of it) and to tell your peers and friends everywhere, so that they too can work towards becoming an ‘A‘ student in English law.

Remember that with ‘The Case Law Compendium’ you can do it.

Electronic Signatures Neil

Chester v Afshar

English Medical Law

Chester v Afshar
Image: ‘No Full Disclosure’ by Robert Burridge

‘But for’ causation and the principles of tort, while reminiscent of criminal procedure, can fall foul to policy loopholes when a duty of care is involved. In this matter, the actions (or inactions) of a neurosurgeon left a patient paralysed and angry after full disclosure had not been established prior to her operation.

After suffering for a number of years with lower back pain, the respondent had reached the point that regular injections were no longer of relief, and had now given serious thought to surgical intervention, despite long standing fears around the field of operative medicine. Having consulted her rheumatologist at length, she was confidently advised to procure the services of a Harley Street practitioner with a solid reputation for the proposed kind of operation.

The recommended procedure involved delicate removal of a number of vertebrae that would by extension, bring an end to her pain, but not without associated risks inherent to the work. Upon her first visit with the appellant, the two individuals took time to discuss the course of action, along with the known side-effects and possible nerve damage. Having consented to undergo the surgery, the respondent was treated a few days following the meeting; after which her recovery was less positive than had been anticipated, and which had in fact left the respondent immobile and diagnosed with cauda equina syndrome.

Having sought damages for what the respondent considered to be negligence through a breach of duty to inform her of the known (and well documented) risks associated with the operation, the first judge found that in order to reach a balanced decision, it was important to address both the breach of duty to fully disclose, and the liability for the subsequent injury arising from the procedure. On this occasion, and relying upon the evidence presented, the court took time to debate the principal function of causation, in which the defendant is not required to establish exemption, but that the claimant must take the necessary steps to demonstrate how their breach caused either injury or loss, and that where adherence to policy and procedure had occurred, the results would have prevented any need for legal remedy.

With judgment found in favour of the respondent in the first hearing, the surgeon moved to appeal, before finding his challenge dismissed for the same reasons. It was then after granting permission to appeal to the House of Lords, that the finer details of causation and right to damages became of greater significance.

While the discussion revolved around similar medical cases applying tortious doctrines of causality, the named risk attached to lumbar stenosis removal ran within a very narrow margin of around one to two percent, and it had been proven as well as agreed, that irrespective of the performing surgeon, the potential for the syndrome remained equally viable. This translated that a lack of absolute disclosure by the appellant, while disconcerting in the immediate sense, could not be held as contributory to the injurious outcome experienced by the respondent.

However, the division between the House was such that enough case material had amassed to instigate a reconsideration of the logic of causality; and that when embracing the autonomous rights of the patient, it was simply unethical to allow minimal disclosure and a weakness of causative proximity to remove access to knowledge, which on this occasion might have led to alternative solutions to pain and discomfort. By then mindfully broadening the duty of care principle, the judges found (by a similarly narrow margin) in favour of the respondent and awarded accordingly, while holding that:

“In modern law medical paternalism no longer rules and a patient has a prima facie right to be informed by a surgeon of a small, but well established, risk of serious injury as a result of surgery.”

 

R (C) v Berkshire Primary Care Trust

English Medical Law

R(C) v Berkshire Primary Care Trust
Image: ‘The Danish Girl’ by Gerda Wegener

Psychological dependence upon a surgical procedure to establish a definite sense of identity, lies within the heart of this matter when a transgender patient experiences disappointment with the outcome of hormone treatment and seeks remedy from the National Health Service (NHS).

Having experienced a life of emotional turmoil and unrelenting conflict with the gender nature afforded him, a man takes the steps required to adjust his gender to that of a woman, inasmuch as reassignment procedures will allow. While not yet at the point of invasive surgery, the appellant elected to follow course of therapy that by its own methodology, would increase his existing breast tissue to that of an average woman; thereby removing any fears that members of society would, on a superficial level, ever confuse him with a man.

At the conclusion of the programme, the appellant was left with only a minimal increase in tissue growth, and the inadequacy felt lingered to the point of mild depression and disillusionment with both himself and the future. Following consultation with his consultant psychiatrist, his case was put forward to the relevant Primary Care Trust, in the hope that both the poor outcome of the biological intervention and the circumstantial criteria of the Gender Dysphoria and Cosmetic Breast Surgery Policies would allow funding for breast augmentation (augmentation mammoplasty) to redress the balance.

Having had prior experience of transgender applications for the mammoplasty, and in the knowledge that current policy considers the procedure to be low priority, the Primary Care Trust conducted independent research to establish if there was sufficient data to support the claim that breast augmentation was important enough to have a positive impact upon a patient’s life and mental health, in claims where such surgical adjustments are compellingly argued.

Despite previous case discussions around the subject, the results of the investigative report concluded that there remained insufficient justification to amend the policy, and so unless in the case of extreme symptoms, the funding could not be provided, and that the patients would need to seek their own source of revenue. When first refused, and in consideration of two complaints to the Health Commission, the second application failed again, before a request for judicial review was presented. On this occasion, the application for review was dismissed, before the appellant moved to argue for funding on grounds of human rights violations and discrimination.

Citing art.8 of the Human Rights Act 1998 (right to respect for private and family life) and art.14 (prohibition of discrimination), it was contested that denial of surgery was a breach of that right, and constituted excessive demands for an emotionally distressed transgender to suffer beyond that of an equally unhappy natural woman when determining eligibility for funding; and that such distinction resulted in nothing less than discrimination between the two types of patient.

Having evaluated the history behind the matter, and the recent investigatory methods used by the NHS, it was concluded that great attention had been placed upon the equality of a patients emotional well-being, and that unilateral guidelines were exacting enough to determine when funding was appropriate. This decision was supported in the decisory notes, which read that any patient seeking to obtain funding for policy procedures must demonstrate (i) that the patient’s case constitutes exceptional circumstances, (ii) that there is evidence of significant health benefit from the requested treatment, and (iii) there is evidence of the intervention improving health status.

On this occasion, the court quickly agreed that despite evidence of ‘chronic mild to moderate distress’ conveyed by the patient’s doctor, there was simply nothing to suggest that his situation was any more exceptional than a patient denied the resources, or that his symptoms were similar to those qualifying, transgender or otherwise, thus the court upheld the claim dismissal while also holding that:

“[G]ender and clinical needs are both relevant characteristics. Their aetiology is relevant diagnostically, but what are more critically relevant are the ethical and clinical judgments of the PCT, provided these do not transgress the law.”

R (Condliff) v North Staffordshire Primary Care Trust

English Medical Law

R (Condliff) v North Staffordshire Primary Care Trust
Image: ‘Daniel Lambert’ by Unknown Artist

Accusations of human rights violations and irrationality of policy, lay behind this failed judicial review hearing, after the denied care trust funding of laparoscopic gastric surgery upon a morbidly obese patient.

While often difficult to draw absolute clarity from NHS guidelines and framework policies, the matter dealt with here stems from a number of misapplications, breakdowns in communication and unwillingness to pursue a claim through the accorded channels. As may, or may not be common knowledge to many, it is operationally agreed that the associated Primary Care Trusts of the United Kingdom are given the freedoms to set (within reason) their own thresholds and qualifying criteria for certain procedures, one of which includes preventative gastric surgeries to patients seen as most in need.

Unfortunately on this occasion, the patients BMI fell short of the required level, despite neighbouring counties demonstrating more lenient grading for the same treatment. Subsequently, when his application for an individual funding request was refused on grounds that his condition failed to meet the prescribed eligibility, the call for judicial review commenced.

Resting upon four reasons for review, the claimant cited that (i) the policy guidelines set by the issuing body were discriminatory, in that they precluded social factors relevant to a claim for exclusivity,  (ii) that as a result of such prohibition, art.8 of the Human Rights Act 1998  (right to respect for private and family life) was in contravention, (iii) that the same breach impacted upon art.6 of the HRA (right to a fair trial), and (iv) that the conclusive argument against funding, lacked clarity enough to satisfy the patient and acting representatives.

Upon close examination of the facts, it was agreed that while no such interferences of human rights could be seen to exist in the former article, the resulting decision of the latter would have remained the same regardless. This position was supported by the observation that social factors were immaterial when deciding the award of funds, and that the prerequisite medical evidence for exception was balanced enough to remain within the two articles presented. In closing, it was also found that the written opinion of the key adjudicating panel consultant, was determinable enough to uphold their decision to reject the application, and that in light of those collective arguments, a judicial review could not stand.

R (Rogers) v Swindon NHS Primary Care Trust

English Medical Law

 

R (Rogers) v Swindon NHS Primary Care Trust
Image: ‘In the Pink!’ by Shelley Ashkowski

To read about this case in greater depth, and with the benefit of full OSCOLA referencing, simply purchase a copy of ‘The Case Law Compendium: English & European Law’ from leading booksellers around the world.

Where can I buy it?

The book is available now through most Amazon sites thanks to the brilliance of Print on Demand (POD) technology and it is also printed through Ingram Spark (aka Lightning Source), who, through their worldwide  partnership agreements, supply ‘The Case Law Compendium’ to almost 40,000 retailers, libraries, schools and universities while providing worldwide shipping as standard.

America Amazon.com, Barnes & Noble

Australia & New Zealand Booktopia

Britain Amazon,   BlackwellWaterstones

Canada AmazonChapters Indigo

France Amazon

Germany Amazon

India Amazon

Italy Amazon

Japan Amazon

Latin America Amazon Brazil Amazon Mexico

Spain Amazon

I cannot emphasise enough just how invaluable this book will become to you as your law course progresses, and you’ll be surprised at just how fast you learn the cases and how your confidence grows when discussing their finer points. I am supremely confident that you will also find yourself returning to the book when studying both for insight and refreshment of knowledge, and I quietly hope you will be equally excited whenever you turn to this unprecedented resource.

Please remember that it was you the worldwide readers, that inspired this book, so you owe it to yourselves to buy it (and use the hell out of it) and to tell your peers and friends everywhere, so that they too can work towards becoming an ‘A‘ student in English law.

– Remember that with ‘The Case Law Compendium’ you can do it.

Electronic Signatures Neil