Sheelagh McGuinness

Research ethics committees: the role of ethics in a regulatory authority

This paper is an examination of how research ethics committees have evolved from being advisory committees to more formal regulatory authorities. It is argued that the role of ethics committees should be broader than simple ethical review. Inconsistency in outcome should not be taken to signal failure. Procedural fairness is of the utmost importance. Nor should ethics committees be seen to diminish the ethical responsibilities of researchers themselves.

Prevention of Transnational Transplant-Related Crimes-What More Can be Done?

Background Many nations are able to prosecute transplant-related crimes committed in their territory, but transplant recipients, organ sellers and brokers, and transplant professionals may escape prosecution by engaging in these practices in foreign locations where they judge the risk of criminal investigation and prosecution to be remote. Methods The Declaration of Istanbul Custodian Group convened an international working group to evaluate the possible role of extraterritorial jurisdiction in strengthening the enforcement of existing laws governing transplant-related crimes across national boundaries. Potential practical and ethical concerns about the use of extraterritorial jurisdiction were examined, and possible responses were explored. Results Extraterritorial jurisdiction is a legitimate tool to combat transplant-related crimes. Further, development of a global registry of transnational transplant activities in conjunction with a standardized international referral system for legitimate travel for transplantation is proposed as a mechanism to support enforcement of national and international legal tools. Conclusions States are encouraged to include provisions on extraterritorial jurisdiction in their laws on transplant-related crimes and to collaborate with professionals and international authorities in the development of a global registry of transnational transplant activities. These actions would assist in the identification and evaluation of illicit activities and provide information that would help in developing strategies to deter and prevent them.

GENDER AND PARENTHOOD: THE CASE FOR REALIGNMENT

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Best Interests and Pragmatism

In this article I will show that ‘best interests’ is a concept that fits nicely with many of the features of pragmatism—Holm and Edgar’s rejection of the principle in favour of pragmatism it will be suggested is misplaced. ‘Best interests’ as a principle may be considered an embodiment of the ideals of pragmatic adjudication. The paper starts by briefly introducing the concept of ‘best interests’ and theories of judicial and legal ‘pragmatism’. This article will examine the role of the rational decision-maker in medical law and argue that this role is limited. The paper concludes by suggesting how we view the relationship between ‘best interests’ and ‘pragmatism’.

A guerrilla strategy for a pro-life England

ABSTRACT Access to safe and legal abortion is integral to womens sovereignty over their own bodies. In this paper I examine current anti-abortion strategising in England. I suggest that the range of anti-abortion activities can be understood as part of a broader ‘Guerrilla Strategy’ to restrict access to abortion care. Such an approach focuses on capitalising on the marginalisation of abortion services and areas of legal ambiguity to make abortion care ‘uncomfortable’ to both access and deliver. Guerrilla strategies rely for success on the marginalisation of abortion care (both physically and ideologically) from mainstream medical practice and flourish within a legal framework that relies on physicians as gatekeepers. The paper ends with a consideration of how we might respond to these anti-abortion strategies; in particular paying attention to the ways we can embrace and encourage provision of services to women through supporting and improving the conditions of the important professional bodies needed to deliver these services.

Principalism: A Method for the Ethics of Emotion-Oriented Machines

This chapter outlines the ‘four principles’ approach which is prevalent in medical ethics. Principalism was adopted as the ethical method of HUMAINE. This chapter introduces this method and also provides an account of the various criticisms of it. The chapter also includes some discussion of the relationship between ethics and scientific research. The purpose of this discussion is to show how ethics and good ethical research can be embedded in scientific practice. In conclusion, the chapter addresses the importance and the usefulness of considering fears that are embodied in works of science fiction when trying to deal with concerns and fears of the public. Consideration of the ethics of the possible is of massive practical importance and indeed should be a priority for those who are working within research groupings like HUMAINE. It is, however, often important to consider the ethics of what may never be possible – the science fiction if you like. When considering the impossible it will be important to stress the fact that these things are not and may never be possible. The role of this type of consideration lies in the importance of public engagement and showing that possible future scenarios are being taken into account by those who are pushing forward science and technology in this area.

Medicine and abortion law: complicating the reforming profession

The complicated intra-professional rivalries that have contributed to the current contours of abortion law and service provision have been subject to limited academic engagement. In this article, we address this gap. We examine how the competing interests of different specialisms played out in abortion law reform from the early twentieth-century, through to the enactment of the Abortion Act 1967, and the formation of the structures of abortion provision in the early 1970s. We demonstrate how professional interests significantly shaped the landscape of abortion law in England, Scotland, and Wales. Our analysis addresses two distinct and yet related fields where professional interests were negotiated or asserted in the journey to law reform. Both debates align with earlier analysis that has linked abortion law reform with the market development of the medical profession. We argue that these two axes of debate, both dominated by professional interests, interacted to help shape laws treatment of abortion, and continue to influence the provision of abortion services today.

DeGrazia on abortion law and policy

In Creation Ethics, David DeGrazia deals with a range of questions that challenge our understanding of ethical reproduction.1 In this short commentary, I wish to focus on DeGrazias treatment of the ethics of abortion and specifically his views on whether abortion should be publically funded. In Chapter 2, entitled ‘Prenatal Moral Status and Ethics’, DeGrazia outlines his views on the ethics of abortion. DeGrazia deals thoughtfully and in a nuanced way with the ethics of prenatal moral status and it is to his credit that he strives to give the fairest reading to a range of pro-life arguments. Aside from scholarly integrity, DeGrazia has a principled commitment to taking seriously those who believe that the foetus/embryo has moral status. His liberal pluralism regarding the permissibility of abortion means that ‘[u]nlike nearly every philosopher I know who holds a liberal view on prenatal moral status and/or the ethics of abortion and embryo research’ he believes ‘that a broadly pro-life approach remains standing as a reasonable option’ (p.43).1 Specifically, DeGrazia ends up endorsing the view that abortion is generally permissible but is it not necessary to publicly fund such care. DeGrazias arguments on the ethics of abortion rest on his defence of a tripartite framework for understanding prenatal moral status. The three prongs of this framework are: 1. A biological essentialist account of identity (p.24).1 2. Sentience is a relevant criterion for moral status (p.29).1 3. A form of the time relative interests argument whereby ‘a right to life depends on a strong interest in remaining alive’ (pp.33–34).1 It is not the purpose of this commentary to engage in a critique of DeGrazias arguments on these points. Rather, the above is outlined so that the reader gets a sense of the basis of DeGrazias position. However, I would like to …

Pioneering Healthcare Law: Essays in Honour of Margaret Brazier

Margaret Brazier has been described as one whose work ‘light[s] the way’1 for those that follow, the ‘paradigmatic female role model for young academics’2, and as a ‘lawyer, whose heart is in the law’.3 We agree and argue that Brazier has a distinctive way of both analysing legal issues and evaluating legal problems. This chapter identifies and examines the distinctive elements of the Brazier method. Drawing on this method, and a case study, we argue that she has made a fundamental contribution to the development of healthcare law. Brazier has highlighted the importance of recognising the humanity of different stakeholders in the healthcare enterprise. Particularly important is her recognition of the fallibility and vulnerability of healthcare professionals alongside patients. Where previously medical law was a tool for confrontation between human patients and machine-like doctors, Brazier has facilitated its evolution into a new role as mediator between fallible and vulnerable players.This book celebrates Professor Margaret Braziers outstanding contribution to the field of healthcare law and bioethics. It examines key aspects developed in Professor Braziers agenda-setting body of work, with contributions being provide by leading experts in the field from the UK, Australia, the US and continental Europe. They examine a range of current and future challenges for healthcare law and bioethics, representing state-of-the-art scholarship in the field.

The science of muddling through: Categorising embryos

Margaret Brazier has been described as one whose work ‘light[s] the way’1 for those that follow, the ‘paradigmatic female role model for young academics’2, and as a ‘lawyer, whose heart is in the law’.3 We agree and argue that Brazier has a distinctive way of both analysing legal issues and evaluating legal problems. This chapter identifies and examines the distinctive elements of the Brazier method. Drawing on this method, and a case study, we argue that she has made a fundamental contribution to the development of healthcare law. Brazier has highlighted the importance of recognising the humanity of different stakeholders in the healthcare enterprise. Particularly important is her recognition of the fallibility and vulnerability of healthcare professionals alongside patients. Where previously medical law was a tool for confrontation between human patients and machine-like doctors, Brazier has facilitated its evolution into a new role as mediator between fallible and vulnerable players.This book celebrates Professor Margaret Braziers outstanding contribution to the field of healthcare law and bioethics. It examines key aspects developed in Professor Braziers agenda-setting body of work, with contributions being provide by leading experts in the field from the UK, Australia, the US and continental Europe. They examine a range of current and future challenges for healthcare law and bioethics, representing state-of-the-art scholarship in the field.