Imogen Goold studied Law and Modern History at the University of Tasmania, Australia, receiving her PhD in 2005. Her doctoral research explored the use of property law to regulate human body parts. She also received a Masters degree in Bioethics from the University of Monash in 2005. From 1999, she was a research member of the Centre for Law and Genetics, where she published on surrogacy laws, legal constraints on access to infertility treatments and proprietary rights in human tissue. In 2002, she took up as position as a Legal Officer at the Australian Law Reform Commission, working on the inquiries into Genetic Information Privacy and Gene Patenting. After leaving the ALRC in 2004, she worked briefly at the World Health Organisation, researching the provision of genetic medical services in developing countries. She is now examining the impact of moral arguments on the regulation of IVF and also writing a book based on her work on body part ownership.
- Who should have the ultimate say over a child’s medical treatment? A series of high-profile withdrawal of care cases have highlighted the full extent of the courts’ authority to make deci-sions on behalf of children in the medical context. In both the Charlie Gard and Alfie Evans litigation, the courts have made clear that they have the power to make medical decisions for children at the point that child’s welfare is engaged. All courts involved in both cases affirmed the orthodox position that the threshold for judicial intervention in disputes about medical care of children is the welfare of the child, often referred to as the “best interests” approach (refer-ring to both the threshold and the test applied to determine what should be done). While no new point of law has been decided in these cases, they are important in that they confirm just how expansive the inherent jurisdiction of the courts in such cases is, extending as far as to prevent parents from removing their child to another jurisdiction to pursue alternative treat-ment. In this paper, we argue that the current threshold for intervention is too low. We argue that prima facie decision-making authority about a child’s medical care should rest with the child’s parents, affording them the ability to choose between the range of medical options available. This authority should yield only where the parents’ decision carries a “serious risk of significant harm” to the child, at which point the court then has the authority to intervene. When it does so, the court should then apply the best interests approach.ISBN: 9780199981878ISBN: 9780198727392In ‘Egg Freezing and Egg Banking: Empowerment and Alienation in Assisted Reproduction’, John A Robertson responds to the American Society of Reproductive Medicine’s statement that oocyte preservation should no longer be considered an experimental treatment. He explores the implications of this development, focusing on the potentially empowering impact of oocyte preservation as a means for women to preserve their fertility. He also engages with concerns about the possibility that such a development may raise issues of alienation. He highlights some of the potential problems that may emerge as women gain the capacity to store and either donate or sell any eggs they do not need for their own reproductive purposes. Much of his paper is valuable and considered, but in places, his views rest on assumptions about women’s attitudes to their fertility, understanding of the technology, and relationship with their gametes that are open to dispute. This paper teases out some of these assumptions and puts pressure on them by drawing on the growing body of data about what women actually do think and feel about fertility issues. It focuses on two of his main concerns---that social egg freezing may give women a false sense of security, and that women may be harmed if a market in eggs leads to their alienation from their gametes. Via this response to Robertson, I aim to redress the tendency often seen in discussions around women, infertility, ageing and empowerment to unquestioningly accept what I argue are stereotypes and assumptions about women’s views and capacity to reason.DOI: 10.1017/S0008197316000556ISBN: 1841138487ISBN: 0306-6800ISBN: 1849465460ISBN: 9781137327468ISBN: 1849465460DOI: 10.1111/1468-2230.12056DOI: 10.1093/medlaw/fwu028Much of the law is concerned with ascribing responsibility. The law of negligence looks for the person who acted without due care, and places on them the responsibility for the outcome. The criminal law responds punitively to those who break its rules, but the accused can avoid being held wholly or partially responsible if she can point to evidence that showed she lacked the capacity to be in charge of her actions. Contract law is based around competent individuals voluntarily taking on obligations to one another, and holds them responsible if they fail in them. Responsibility is demonstrably a key concept in the law of England, and therefore we should be particularly interested in technology that can affect an individuals capacity to be responsible. In this chapter, we look at one particular area of English law in which new drugs are potentially changing our capacities, and hence (arguably) our responsibilities: cognitive enhancers.The articles in this Special Issue consider recent developments in the law regulating the use of human bodily material and the wider implications of those developments. For some time, the law has accepted that a person who has undertaken "work and skill" on excised bodily material may obtain at least a possessory right; but the person from whom the material came did not have such a right. Now, however, the law has recognised that people may have some legal rights regarding their own bodily material. What is the nature and source of those rights? Should they be expanded? If so, what legal principles are best to do that? The most frequent suggestion is the law of property but many other areas of law are also relevant: the law of contract; tort (bailment and consent); criminal law (eg forensic testing); gifts; custodianship and others. These regulatory options are outlined in this Editorial and discussed by lawyers and other contributors in their articles in this Special Issue. There are also stimulating philosophical reflections on the nature of human bodily material.This article presents the case for taking a property approach in regulating the use of human bodily material. It examines the current debates on the issue and outlines the various perspectives, ranging from the anti-property stance, through the spectrum of positions on modified and semi-proprietary approaches, through to the "full-blooded" property approach advocated by some commentators. It elucidates why those approaches that allow some proprietary aspects into regulation are to be preferred.DOI: 10.1136/medethics-2012-100539The 19th and 20th centuries were notable for two major and concurrent changes which have helped to shape modern Britain. It is the interplay of these processes which is the subject of this collected volume. One was the rapid development of medical science, which progressed through various stages allowing it increasingly to assert the scientific certainty of medical conclusions or opinions. Over the same period, the role and regulatory activities of British government were significantly extended. Parliament began to pass legislation on a much broader range of issues than it had previously attempted. This wider sphere included medical practice. The increased scientific certainty of medical conclusions gave those conclusions greater utility to the State when it engaged in fact-finding exercises and accounts, in part, for the increasing appearance of medical experts, opinion, and evaluation of medical practice in its law making bodies.ISBN: 978-1-84113-849-7This chapter examines the ethical debate from the early 1970s through to the end of the first parliamentary debate on the Unborn Children (Protection) Bill in 1985, and explores the role doctors played in it. When new technologies emerge now, much of the exploration of the issues they raise occurs within the now well-established academic field of bioethics, as well as within medicine and science themselves. But in 1978, bioethics as a discipline was in its infancy and there were few people specifically trained in exploring the ethical dimensions of science and how it should be regulated. There was little expertise to help those needing guidance on how to proceed. Yet, control was considered desperately necessary, either to prevent unethical research such as that which used human embryos, or to stave off developments that might be put to problematic uses like eugenic selection and surrogacy. At the time, scientists and doctors working in IVF and embryo research were characterised as unable to self-regulate, bent on pursuing their research goals regardless of the ethical objections to what they might achieve. However, in reality, many in the medical and scientific community both appreciated the ethical dilemmas their work presented, and welcomed regulation and guidance to help them deal with these problems. As a result, much of the debate about how IVF was to be controlled occurred within the medical profession, whose publicly voiced opinions in the science literature, news media and later as evidence to the Warnock Committee were highly influential. Doctors and researchers also made important contributions to the Parliamentary process that eventually led to the passage of legislation in 1990. This chapter brings this influence to the fore, and examines how doctors and medical researchers in this period bore very little resemblance to the mad scientists whose spectre was invoked by those who feared the worst.ISBN: 978-1-84113-849-7This article explores the social benefits and moral arguments in favour of women and couples freezing eggs and embryos for social reasons. Social IVF promotes equal participation by women in employment; it offers women more time to choose a partner; it provides better opportunities for the child as it allows couples more time to become financially stable; it may reduce the risk of genetic and chromosomal abnormality; it allows women and couples to have another child if circumstances change; it offers an option to women and children at risk of ovarian failure; it may increase the egg and embryo pool. There are strong arguments based on equal concern and respect for women which require that women have access to this new technology. Freezing eggs also avoids some of the moral objections associated with freezing embryos.ISBN: 02699702This book investigates how the requirements, limitations and intellectual structure of the British legal process have shaped medicine and medical practice. The story of this inter-relationship is greatly under-researched, which is particularly concerning given that the legal system remains a significant and pervasive influence on medicine and its practice to this day. The question which unifies the series of historical studies presented here is whether legal consideration of medical practice and concepts has played a part in the construction of medical concepts and affected developments in medical practice - in other words how the external, legal gaze has shaped the way medicine itself conceptualises some of its practices and classifications. The majority of the chapters consider this question in the context of the development and application of legislation, but the influence of court processes is also considered. Other themes which emerge from the book include the nature and exclusivity of medical expertise, the impact of public opinion on the development of medical legislation, and the difficulty the legal system has faced in dealing with new medical developments. The chapters are arranged chronologically, with an introduction drawing out themes that emerge from the chapters as a whole.ISBN: 978-1-84113-849-7Only around 50% of women who postpone childbearing until their 30s conceive in the 6 years following. Infertility causes significant harm to those who suffer it, and we argue for promoting access to treatments, such as cryopreservation of eggs, to enable women to pursue their reproductive goals as they choose.ISBN: 15265161ISBN: 17438462ISBN: 1920831274/14424959ISBN: 13212753ISBN: 1079-7572ISBN: 1320-159XISBN: 1079-7572ISBN: 1445-2766ISBN: 1445-2766ISBN: 07334 19240
Reproductive medicine, history of reproductive medicine, bioethics, property
Options taughtJurisprudence, Tort, Medical Law and Ethics (FHS)
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