The legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment: part 1 (New South Wales)

This is the first article in a series of three that examines the legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment from adults who lack capacity. This article considers the position in New South Wales. A review of the law in this State reveals that medical professionals play significant legal roles in these decisions. However, the law is problematic in a number of respects and this is likely to impede medical professionals' legal knowledge in this area. The article examines the level of training medical professionals receive on issues such as advance directives and substitute decision-making, and the available empirical evidence as to the state of medical professionals' knowledge of the law at the end of life. It concludes that there are gaps in legal knowledge and that law reform is needed in New South Wales.     

The legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment: Part 3 (Victoria)

This is the final article in a series of three that examines the legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment from adults who lack capacity. This article considers the position in Victoria. A review of the law in this State reveals that medical professionals play significant legal roles in these decisions. However, the law is problematic in a number of respects and this is likely to impede medical professionals' legal knowledge in this area. The article examines the level of training that medical professionals receive on issues such as refusal of treatment certificates and substitute decision-making, and the available empirical evidence as to the state of medical professionals' knowledge of the law at the end of life. It concludes that there are gaps in legal knowledge and that law reform is needed in Victoria. The article also draws together themes from the series as a whole, including conclusions about the need for more and better medical education and about law reform generally.     

Legal education in the training of health professionals in Ghana: the need for legislative and curricular reforms

The present paper critically analyses the essence of legal education in the training of medical professionals in Ghana. It argues that health professionals lack the requisite knowledge in law, especially the legal implications of medical malpractice, and calls for legislative and curricular reforms in institutions engaged in the training of health professionals to reflect a legal education component. The authors opine that the basic medical law curriculum should be focused on the kinds of legal problems that physicians encounter most frequently in practice rather than on sensational cases. The authors are of the view that the curriculum should address the clarification of central concepts in law, the ability to apply the concepts, decision‐making procedures, acquisition of legal knowledge in tortuous and criminal matters relevant to the medical profession. This view sets objectives for teaching medical law to medical students and young doctors.     

Charting a course through difficult legislative waters: tribunal decisions on life-sustaining measures

Since the enactment in Queensland of the Powers of Attorney Act 1998 (Qld) and the Guardianship and Administration Act 2000 (Qld), a decision can be made to withhold or withdraw life-sustaining medical treatment from an adult who lacks capacity to make such decisions for herself or himself. The Guardianship and Administration Tribunal of Queensland has been asked to consider the law in relation to these decisions on a number of occasions since the legislation was passed. This article explores the relevant provisions of these statutes and some of the difficulties that arise from how they are currently drafted. It also examines how the Guardianship and Administration Tribunal has dealt with applications to withhold or withdraw life-sustaining measures, and suggests a course that might avoid some of the difficulties that are inherent in Queensland's legislative regime.     

Passing it on: should health care professionals be permitted to disclose patients' genetic information to their reproductive partners?

This article considers whether Australian law should permit health care professionals to disclose patients' genetic information to their reproductive partners without the patients' consent. The issue is addressed with reference to four genetic disorders (Huntington Disease, Familial Adenomatous Polyposis, Multiple Endocrine Neoplasia Type 2A and Cystic Fibrosis) which illustrate differences in inheritance traits and availability of effective treatments. The article explores the familial nature of these disorders and the notion that genetic information has implications which extend beyond the individual patient to third parties such as reproductive partners. It addresses the opinions of legal academics and regulatory bodies regarding the potential amendment of Australian laws to permit such disclosure. Ultimately, it is submitted that the application of current laws regarding medical information to the needs of genetics is unlikely to generate adequate results. To allow for a more appropriate response to this debate, health care professionals' duties to patients should be qualified when it concerns reproductive partners.     

Expert evidence and medical manslaughter: vagueness in action

This article examines the reliance placed on expert evidence in prosecutions of health professionals for gross negligence manslaughter, where juries must decide whether conduct goes beyond civil negligence and constitutes the crime of involuntary manslaughter. It argues that the test for liability is vague and examines some of the consequences of this. Given the vagueness of the offence, jurors are likely to place great reliance on expert medical evidence. Little is known about how experts negotiate the legal process, empirically speaking: how they approach their task, how they view their role as expert witnesses, and the attitudes, biases, and beliefs that may underpin their testimony. Drawing on the experiences and perceptions often medical experts, this article explores how experts manage the vagueness inherent in the task of interpreting and applying gross negligence. Experts appear to go beyond offering purely medical opinion and enjoy engaging with law and the legal process.     

Queensland general practitioners' applications of the "mature minor" principle: the role of patient age and gender

Most Australian jurisdictions do not have legislation that stipulates an age by which a minor can make their own medical treatment decisions. Instead, they rely on Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112, an English common law decision that recommends individual assessments of "maturity". This study explores how medical practitioners in the State of Queensland understand and apply this legal authority when faced with a young person wishing to make a contentious medical treatment decision. Almost 200 doctors made decisions about a hypothetical patient's competence and confidentiality, and detailed their reasoning in an open-ended format. The data indicate that the vagaries of existing legal criteria allow for a range of philosophical perspectives and idiosyncratic heuristics to play a role in assessment practices, and that particular combinations of patient age and gender made these cognitive shortcuts more likely to occur. A notable proportion of such processes are not consistent with legal guidelines, and this has implications for general practitioners' vulnerability to litigation as well as young patients' treatment trajectories.     

The doctrine of informed consent: a tale of two cultures and two legal traditions

In this article, the author compares and contrasts the notion of informed consent in medical decision making in the Western legal system with the traditional Jewish biblical legal system. Walter critically examines the philosophical underpinnings of disease and medical healing in both legal systems, and describes the practical consequences that emanate from the different ideologies in terms of the individual's rights of choice of treatment. She explains that the Western system is predicated on notions of individual autonomy and self determination. Patients therefore have the autonomous ability to select and direct their own medical therapy. By contrast, the traditional biblical system of law is based on the concept that the body does not belong to the individual. Instead, the body is given to man by God as a trust to respect and preserve. Therefore, the individual patients "has no absolute right to control his body and ... he has no real decision making power as to medical treatment choices." In the Jewish biblical tradition, consent is not necessary for obviously beneficial or obviously non-beneficial procedures; consent is only necessary in decisions with uncertain outcomes or when making choices between equal options. Patients are encouraged to seek the counsel of religious authorities and to conform to rabbinical interpretations of the traditional Jewish law.     

From European Integration to European Integrity: Should European Law Speak with Just One Voice?

Abstract: This article examines whether and how the moral principle of legal coherence or integrity, which has recently been developed further as a response to disagreement in the national legal context, applies to European law. According to the European integrity principle, all national and European authorities should make sure their decisions cohere with the past decisions of other European and national authorities that create and implement the law of a complex but single European legal order. Only by doing so, it is argued, can the European political and legal community gain true authority and legitimacy in the eyes of the European citizens to whom all these decisions apply. Although European integrity is primarily a product of European integration, it has gradually become one of the requirements of further integration. The article suggests that the principle of European integrity would help dealing with the growing pressure for common European solutions under conditions of increasing diversity. It places disagreement at the centre of European politics, as both an incentive and a means of integration by way of comparison and self‐reflectivity. It constitutes therefore the ideal instrument for a pluralist and flexible further constitutionalisation of the European Union.     

Intraprofessional Competition and Earnings Inequalities Across a Professional Chasm: The Case of the Legal Profession in Québec,Canada

Intraprofessional rivalry has a long history. This article examines earnings disparities as a dimension of intraprofessional competition among avocats and notaires in the civil law system of Québec, Canada. Drawing on two large‐scale surveys and in‐depth interviews with legal professionals, I examine three competing perspectives of earnings inequalities: human capital, social‐symbolic capital, and organizational‐structural explanations. Through this analysis I seek to examine whether similar causal processes shape earnings across the two spheres of legal practice in Québec. The findings of this study clearly demonstrate that these two professional groups are equipped with differential stocks of capital, and conversion rates differ drastically. Avocats receive greater exchange on their investments in human and social‐symbolic capitals. These disparities are most pronounced in sectors of the profession where jurisdictional frictions abound: among notaires and avocats working as solo practitioners and in small firms within competitive urban contexts. The article concludes with a discussion of theoretical extensions and future directions for the study of legal professionals in civil law systems and blended jurisdictions.     

End-of-life decisions in Italy: an overview of the current situation

This contribution analyzes end-of-life decisions in Italy. Its aim is to report the complex situation in end-of-life decisions. The scientific work applies an interdisciplinary approach by taking into consideration the position of the medical and biomedical communities. In addition, it examines the perspective of the jurisprudence and of the parliament. The investigation of all these parties is fundamental since Italy is one of the few Western European countries that does not have an ad hoc law ruling advance directives. After a complete and comprehensive study of the standpoint taken by the medical and biomedical communities, in addition to the position taken by the Italian law-maker, this contribution underlines the significance of the role of the jurisprudence. In the conclusions, the author underlines the significance of a specific law governing advance directives since it will end the contrasts between these different communities in addition to provide legal certainty.     

台湾法学教育之可能性解释

法学教育与法制背景之间息息相关。台湾近一百多年来,历经清朝、日治、民国三次不同政权更迭。1980年,台湾解除戒严统治、终止动员戡乱时期后,政治趋于自由化、民主化,执政当局对于高等教育管制渐趋松绑,法律系所遂伴随大学数量上升亦呈现高速发展之盛况。但是,整体而言,台湾除法律人以外,社会法治化程度可谓不高。1990年以后,法律系、所虽然逐年增加,但因政策因素导致法律人予人之图像即为法曹,政府及社会大众似乎认为“法律知识乃法律人之事”。本文因此尝试提出台湾法学教育未来可能方向,以供参考、研议。     

Wrong about Rights: Public Knowledge of Key Areas of Consumer,Housing and Employment Law in England and Wales

Over many decades, processes of juridification have brought about huge growth in legal rights, responsibilities and protections, yet citizens appear to poorly understand this ‘law thick’ world. This impacts citizens’ capacity to ‘name, blame and claim’ in the legal domain at a time of retreat from public funding of civil legal services. This article examines public knowledge of rights in key areas relating to consumer, housing and employment law. Drawing on data from the 2010–2012 English and Welsh Civil and Social Justice Survey, the article uses responses to a series of hypothetical scenarios to explore public knowledge of rights and characteristics associated with knowledge. Our findings highlight a substantial deficit in individuals’ understanding of legal rights and responsibilities – even among those for whom particular rights and responsibilities have specific bearing. We also consider what these findings mean for public legal education and the efficiency, efficacy and legitimacy of the law.     

Kumarangk (Hindmarsh Island) and the Politics of Natural Justice under Settler‐Colonialism

This article examines the impact of the application of apparently impartial principles of procedural fairness and natural justice on the construction of “authentic” and “inauthentic” knowledge of Aboriginal culture. It discusses the progression of the Kumarangk (Hindmarsh Island) court cases and the legal construction of public participation in the making of political decisions affecting Aboriginal interests in land. In examining the politics of competing interests in land, this article reflects on the tension between Indigenous interests in land and settler developmentalism in relation to the Australian jurisprudence of procedural fairness and natural justice. The arguments running through the article concern the questions of the ways in which the liberal restraint on power is embodied in the impartial principles of administrative law, where that power creates rather than infringes upon rights, why it generates a particular legal construction of Aboriginal interests in land and cultural heritage, and the extent to which this plays a role in the maintenance of relations of settler‐colonial dispossession.     

Contested views of expertise in children’s care and permanence proceedings

In this article, we consider different perspectives on who is best able to provide relevant and helpful expertise in public law cases where the long-term care of children is under consideration. Opinions vary and sometimes conflict on the respective importance of legal, child development, and lay understandings. These opinions relate to views on rights, appropriate procedures, decision-making processes, and the effects of decisions on children. Firstly, we summarise literature relevant to the knowledge and skills of three key groups of decision-makers within the Scottish child care system: legal professionals, child care professionals and lay decision-makers, and outline literature about guardians ad litem and their counterparts. We then discuss issues of expertise emerging from a study exploring the reasons for, and impact of, the appointment of safeguarders (who, in Scotland, perform a similar role to guardians). We conclude that there may be an increasing tendency for disagreement and a lack of clarity about who brings the most relevant and helpful expertise to hearings; this may have negative effects for children.     

Epistemic emotions in prosecutorial decision making

The article examines epistemic emotions as part of the emotive-cognitive processes of prosecutors’ knowledge seeking and decision making in preliminary investigation and court proceedings. Drawing on ethnographic fieldwork, interviews, and shadowing of prosecutors in Sweden, we show how emotions motivate and orient prosecutors’ inquiries and the fundamental role of the ‘certainty–doubt spiral’ for ‘doing objectivity’. In conclusion, we discuss the centrality of emotions for conscientious and well-considered decisions in legal work. The study contributes to the field of law and emotion by exploring the epistemic quality of emotions, notably the certainty–doubt spiral, in legal work.     

Euthanasia: another face of murder

Debate over euthanasia is not a recent phenomenon. Over the years, public opinion, decisions of courts, and legal and medical approaches to the issue of euthanasia has been conflicting. The connection between murder and euthanasia has been attempted in a few debates. Although it is widely accepted that murder is a crime, a clearly defined stand has not been taken on euthanasia. This article considers euthanasia from the medical, legal, and global perspectives and discusses the crime of murder in relation to euthanasia, taking into consideration the issue of consent in the law of crime. This article concludes that in the midst of this debate on euthanasia and murder, the important thing is that different countries need to find their own solution to the issue of euthanasia rather than trying to import solutions from other countries.     

Legal Change on Contraceptive Sterilisation

New and controversial medical procedures such as contraceptive sterilisation are often thought, at least initially, to be prohibited by the criminal law. This article examines how – without any formal legal intervention – contraceptive sterilisation for a consenting patient eventually became accepted as lawful in the United Kingdom. A prominent role was played by the medical profession, its organisations and its journals. A significant role was played by a little-known campaigning organisation in ensuring this legal change.     

Constructing Police Abuse after Rodney King: How Skid Row Residents and the Los Angeles Police Department Contest Video Evidence

This ethnographic article explores the manner in which the Los Angeles Community Action Network (LACAN), a grassroots organization made up of homeless and low‐income Skid Row residents, generates video evidence for use in lawsuits against the Los Angeles Police Department (LAPD). For marginalized communities fighting police abuse, the 1992 acquittal of four LAPD officers charged with the beating of Rodney King demonstrated that even the most “obvious” and condemning video evidence is subject to reinterpretation and reframing by skilled legal professionals. In response, LACAN has developed interactional filming strategies designed to constrain officers' ability to offer alternative explanations, while alleviating disparities in court‐recognized authority. In the tradition of legal consciousness scholarship, this article “de‐centers” the law by shifting emphasis from formal judicial decisions in the courtroom to citizen groups in their own communities, as they learn to use legal norms and conventions in social justice campaigns.     

医事法学专业课程设置之思考

医事法学专业是培养既懂医又懂法的应用型、复合型人才。适应学科特点,明确培养目标,在教学队伍、课程体系和教学内容等方面下工夫,使医事法学本科教育实现新的创新。