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Sherr, Avrom, e Lisa Webley. "Legal ethics in England and Wales". International Journal of the Legal Profession 4, n.º 1-2 (março de 1997): 109–38. http://dx.doi.org/10.1080/09695958.1997.9960428.
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Alderson, Priscilla, Bobbie Farsides e Clare Williams. "Examining Ethics in Practice: health service professionals’ evaluations of in-hospital ethics seminars". Nursing Ethics 9, n.º 5 (setembro de 2002): 508–21. http://dx.doi.org/10.1191/0969733002ne541oa.
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This article reviews practitioners’ evaluations of in-hospital ethics seminars. A qualitative study included 11 innovative in-hospital ethics seminars, preceded and followed by interviews with most participants. The settings were obstetric, neonatal and haematology units in a teaching hospital and a district general hospital in England. Fifty-six health service staff in obstetric, neonatal, haematology, and related community and management services participated; 12 attended two seminars, giving a total of 68 attendances and 59 follow-up evaluation interviews. The 11 seminars facilitated by an ethicist addressed the key local concerns of staff about the social and ethical consequences of advances in genetics and their impact on professional policies and practice. Seminar agendas were drawn from prior interviews with 70 staff members. During evaluation interviews, participants commented on general aspects that they had enjoyed, how the sessions could be improved, timing, the mix of participants, the quality of the facilitation, whether sessions should be more challenging, after-effects of sessions, and interest in attending seminars and contacting the ethicist in future. Participants valued the increased interprofessional understanding and coherent discussion of many pressing issues that addressed important though seldom discussed ethical questions. The seminars worked well in the different hospitals and specialties.
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Lloyd, Ann. "Ethics Committees in England". Hastings Center Report 18, n.º 5 (11 de outubro de 1988): 2. http://dx.doi.org/10.2307/3562211.
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Jones, RG. "Ethical and legal issues in the care of people with dementia". Reviews in Clinical Gerontology 11, n.º 3 (agosto de 2001): 245–68. http://dx.doi.org/10.1017/s0959259801011364.
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This paper addresses some ethical and legal issues which arise in the UK in the care of people with dementia, focusing on the law in England and Wales – updating and revising the 1997 and earlier version. The ‘end of medical ethics’ continues to be debated, with an attendant fear of doctors’ responsibility and authority being fatally eroded by administrators and cost controllers, concerned only with budgets and ‘bureaucratic parsimony’.
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Griffiths-Baker, Janine. "Reviewing Legal Ethics and Legal Education in England and Wales—An Unenviable Task?" Legal Ethics 10, n.º 2 (janeiro de 2007): 121–23. http://dx.doi.org/10.1080/1460728x.2007.11423887.
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Krawczyk, Rosemary M. "Teaching Ethics: Effect on Moral Development". Nursing Ethics 4, n.º 1 (janeiro de 1997): 57–65. http://dx.doi.org/10.1177/096973309700400107.
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The purpose of this study was to determine the development of moral judgement in first-year and senior baccalaureate nursing students. These students were enrolled in three separate nursing programmes, each of which differed significantly in ethical content. The sample totalled 180 students enrolled in three New England programmes. Programme A included an ethics course taught by a professor of ethics. Programme B integrated ethical issues into all nursing theory courses. Programme C did not include ethical content in theory courses. The design was of a developmental cross-sectional study. The dependent variable was the development of moral judgement, as measured by Rest’s Defining Issues Test. The independent variable was the amount of ethics taught in the nursing programmes and the level of academic education. The senior nursing students from programme A scored significantly higher than the other senior groups on the Defining Issues Test. The conclusion is that an ethics course with group participation and a decision-making element significantly facilitated nursing students’ development of moral judgement.
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Madhloom, Omar. "A Kantian Moral Cosmopolitan Approach to Teaching Professional Legal Ethics". German Law Journal 23, n.º 8 (outubro de 2022): 1139–57. http://dx.doi.org/10.1017/glj.2022.74.
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AbstractThis article argues that given the globalization of legal education and legal services, professional legal ethics should incorporate not only a cosmopolitan dimension but also sentiments such as compassion, respect, and sensitivity for human suffering. Inspired by the philosophy of Immanuel Kant and his theory of education, this article seeks to address some of the limitations of the professional codes of conduct for barristers and solicitors, in England and Wales, by applying a moral cosmopolitan approach to the teaching of professional legal ethics. This normative approach is underscored by a commitment to moral duties to persons irrespective of their nationality, gender, religion, or any other defining characteristic. These duties include promoting client autonomy and engaging in law reform. This article also argues that Clinical Legal Education programs are an appropriate methodology for teaching moral cosmopolitan ethics.
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Christopher, M. Green, e Laurence J. Naismith. "A Comparative Perspective on Forensic Psychiatry in Canada and England". Medicine, Science and the Law 28, n.º 4 (outubro de 1988): 329–35. http://dx.doi.org/10.1177/002580248802800413.
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ABSTRACT: An outline is presented of the development and practice of forensic psychiatry, including relevant legal aspects, in Canada, in comparison to the English system. It is written by two English-trained psychiatrists, who have provided forensic services in both Canada and England. Canadian forensic psychiatry is portrayed as having a greater medico-legal emphasis than at present in England, with a continuing dependence on the insanity verdict for seriously mentally disordered offenders. Canadian forensic psychiatric institutions are often attached to the correctional system, whereas in England they are under the Department of Health. Within this framework, the article elaborates upon clinical and medico-legal differences.
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Taylor, Richard, e Jessica Yakeley. "Working with MAPPA: ethics and pragmatics". BJPsych Advances 25, n.º 3 (11 de fevereiro de 2019): 157–65. http://dx.doi.org/10.1192/bja.2018.5.
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SUMMARYMulti-agency public protection arrangements (MAPPA) have been in operation for around 18 years in England and Wales. The primary purpose is for the sharing of information between agencies regarding the risk management of offenders returning to the community from custodial and hospital settings. The legal framework regarding information by psychiatrists is not dealt with in one single policy or guidance document. Psychiatrists must use their clinical and professional judgement when engaging with the MAPPA process, mindful of guidance available from professional bodies such as the Royal College of Psychiatrists, General Medical Council and British Medical Association.LEARNING OBJECTIVESAfter reading this article you will be able to: •Learn the legal and political background that led to the formation of MAPPA•Understand the structure and function of MAPPA•Understand the role of psychiatrists in the MAPPA processDECLARATION OF INTERESTR.T. is a member of the London Strategic Management Board for MAPPA.
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Dunn, Michael, Krysia Canvin, Jorun Rugkåsa, Julia Sinclair e Tom Burns. "An empirical ethical analysis of community treatment orders within mental health services in England". Clinical Ethics 11, n.º 4 (7 de julho de 2016): 130–39. http://dx.doi.org/10.1177/1477750916657654.
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Community treatment orders are a legal mechanism to extend powers of compulsion into outpatient mental health settings in certain circumstances. Previous ethical analyses of these powers have explored a perceived tension between a duty to respect personal freedoms and autonomy and a duty to ensure that patients with the most complex needs are able to receive beneficial care and support that maximises their welfare in the longer-term. This empirical ethics paper presents an analysis of 75 interviews with psychiatrists, patients and family carers to show how these ethical considerations map onto the different ways that community treatment orders are used and experienced in practice. A complex and nuanced account of how the requirements to respect patients’ autonomy, to respect patients’ liberty and to act beneficently should be interpreted in order to make judgements about the ethics of community treatment orders is presented. The article argues that, due to such complexity, no general ethical justification for community treatment orders can be provided, but a justification on the basis of the promotion of patients’ autonomy could provide an ethical reason for community mental health practitioners to make use of a community treatment order in some limited circumstances.
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Friedel, Tomáš. "An Ethically Indifferent Code of Ethics? Analysis of the Character of the Czech Bar Association’s Code of Ethics". AUC IURIDICA 69, n.º 2 (7 de junho de 2023): 155–69. http://dx.doi.org/10.14712/23366478.2023.21.
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The Czech Bar Association published a text which has the words “code of ethics” in its title. The aim of this paper is to determine whether the norms contained in the code are actually related to ethics or whether they concern different fields. The paper first explains the raison d’être of codes of ethics in general and briefly introduces the Czech Bar Association and the origin of its code of ethics. The principal section of the paper is dedicated to a detailed analysis of the text of the Czech Bar Association’s code of ethics applying a method used in England for similar purposes by Donald Nicolson. The analysis shows that the Czech Bar Association’s code of ethics deals with ethical issues only to a lesser extent and that it contains numerous provisions which do not deal with ethics at all. The paper proposes to remedy this unsuitable state by creating two separate codes. The first would primarily regulate ethically relevant situations in legal practice. The other code would contain “other” rules of the profession.
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Davison, A. M., J. H. McFarlane e J. C. Clark. "Differences in Forensic Pathology Practice between Scotland and England". Medicine, Science and the Law 38, n.º 4 (outubro de 1998): 283–88. http://dx.doi.org/10.1177/002580249803800403.
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Scotland and England are part of the United Kingdom but have separate legal systems. These legal differences have a substantial effect on forensic pathology practice, and are probably best appreciated by those pathologists who have worked on both sides of the border. This paper seeks to highlight the differences in forensic pathology practice between Scotland and England, discussing the investigation of death in both countries. It concludes that a knowledge of the Scottish procurator fiscal system of death investigation may be beneficial to those contemplating changes to the coroner system. All three authors have practised forensic pathology in Scotland and England or Wales.
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Barlow, Nichola Ann, Janet Hargreaves e Warren P. Gillibrand. "Nurses’ contributions to the resolution of ethical dilemmas in practice". Nursing Ethics 25, n.º 2 (3 de maio de 2017): 230–42. http://dx.doi.org/10.1177/0969733017703700.
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Background: Complex and expensive treatment options have increased the frequency and emphasis of ethical decision-making in healthcare. In order to meet these challenges effectively, we need to identify how nurses contribute the resolution of these dilemmas. Aims: To identify the values, beliefs and contextual influences that inform decision-making. To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice. Design: An interpretive exploratory study was undertaken, 11 registered acute care nurses working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification. Participants and context: Participants were interviewed about their contribution to the resolution of ethical dilemmas within the context of working in an acute hospital ward. Participants were recruited from all settings working with patients of any age and any diagnosis. Ethical considerations: Ethical approval was obtained from the local National Research Ethics Committee. Findings: Four major themes emerged: ‘best for the patient’, ‘accountability’, ‘collaboration and conflict’ and ‘concern for others’. Moral distress was also evident in the literature and findings, with moral dissonance recognised and articulated by more experienced nurses. The relatively small, single-site sample may not account for the effects of organisational culture on the results; the findings suggested that professional relationships were key to resolving ethical dilemmas. Discussion: Nurses use their moral reasoning based on their beliefs and values when faced with ethical dilemmas. Subsequent actions are mediated though ethical decision-making frames of reference including deontology, consequentialism, the ethics of care and virtue ethics. Nurses use these in contributing to the resolution of these dilemmas. Nurses require the skills to develop and maintain professional relationships for addressing ethical dilemmas and to engage with political and organisational macro- and micro-decision-making. Conclusion: Nurses’ professional relationships are central to nurses’ contributions to the resolution of ethical dilemmas.
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Naughton, Corina, Elaine Meehan, Elaine Lehane, Ciara Landers, Sarah Jane Flaherty, Aoife Lane, Margaret Landers et al. "Ethical frameworks for quality improvement activities: an analysis of international practice". International Journal for Quality in Health Care 32, n.º 8 (14 de agosto de 2020): 558–66. http://dx.doi.org/10.1093/intqhc/mzaa092.
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Abstract Purpose To examine international approaches to the ethical oversight and regulation of quality improvement and clinical audit in healthcare systems Data sources We searched grey literature including websites of national research and ethics regulatory bodies and health departments of selected countries. Study selection National guidance documents were included from six countries: Ireland, England, Australia, New Zealand, the United States of America and Canada. Data extraction Data were extracted from 19 documents using an a priori framework developed from the published literature. Results We organized data under five themes: ethical frameworks; guidance on ethical review; consent, vulnerable groups and personal health data. Quality improvement activity tended to be outside the scope of the ethics frameworks in most countries. Only New Zealand had integrated national ethics standards for both research and quality improvement. Across countries, there is consensus that this activity should not be automatically exempted from ethical review but requires proportionate review or organizational oversight for minimal risk projects. In the majority of countries, there is a lack of guidance on participant consent, use of personal health information and inclusion of vulnerable groups in routine quality improvement. Conclusion Where countries fail to provide specific ethics frameworks for quality improvement, guidance is dispersed across several organizations which may lack legal certainty. Our review demonstrates a need for appropriate oversight and responsive infrastructure for quality improvement underpinned by ethical frameworks that build equivalence with research oversight. It outlines aspects of good practice, especially The New Zealand framework that integrates research and quality improvement ethics.
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Menezes, S. B., F. Oyebode e M. S. Haque. "Mentally disordered offenders in Zimbabwe and in England and Wales: a socio-demographic study". Medicine, Science and the Law 47, n.º 3 (julho de 2007): 253–61. http://dx.doi.org/10.1258/rsmmsl.47.3.253.
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Our aim was to compare socio-demographic, clinical and criminal characteristics of mentally disordered offender patients in a special institution in a developing and a developed country. Zimbabwe data from 1980-1990 was obtained from a hospital patient survey, in a written semi-structured format. The English special (high security) hospital patients' data for the same period was obtained from the case register. The sample size for Zimbabwe was 367 patients (337 males, 30 females) and for England and Wales it was 1,966 patients (1,643 males, 323 females). The average age for Zimbabwean patients was 36 years, with standard deviation of 9.7; for England and Wales the average age was 29.7 with standard deviation of 9.6. There was significant difference in marital status in the two countries. Seventy-eight per cent of patients were single in England and Wales, compared with 49% in Zimbabwe. There were 20% illiterate patients in Zimbabwe, compared with 4% in England and Wales. Thirty-seven per cent of the patients in England and Wales had a diagnosis of personality disorder, compared with 6% in Zimbabwe. There were 53% of homicides in Zimbabwe, compared with 20% in England and Wales. Employment in the two countries was similar: 34% in Zimbabwe and 33% in England and Wales. There were differences in the socio-demographic characteristics in the two countries, except for employment status. Differences were also noticed in the diagnoses of the patients, types of crime and the methods of assault.
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Marks, M. N., e R. Kumar. "Infanticide in England and Wales". Medicine, Science and the Law 33, n.º 4 (outubro de 1993): 329–39. http://dx.doi.org/10.1177/002580249303300411.
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In England and Wales children under one year of age are at four times greater risk of becoming victims of homicide than either older children or the general population. The annual rate of infant homicide (45 per million) has remained relatively constant since the Homicide Act (1957) in contrast with a progressive fall in the infant mortality rate. Details from Home Office records of all infants under a year who were the victims of homicide during 1982–1988 are presented. Infants were most at risk on the first day of life — neonates accounted for 21% of victims and 13% of the victims were between one day and one month old. Thereafter the proportion decreased steadily so that by the final quarter of the first year the risk of becoming a homicide victim equalled that of the general population. Excluding neonates, there were more male victims than female ones, especially in the first three months. A parent was the most likely perpetrator. For all neonaticides the mother was recorded as a suspect, 36% of these mothers were subsequently indicted, all but two were convicted of infanticide and all their convictions resulted in probation. For children over a day marginally more fathers than mothers were recorded as the prime suspect. Mother and father suspects were equally likely to be indicted and also equally likely to be convicted of a homicide offence. However, mothers received both less severe convictions and less severe sentences than fathers. Fathers were more likely than mothers to have killed their infants using violence which wounded. Nonetheless sentences were unrelated to the brutality of the offence: mothers who had killed with wounding violence received less severe penalties than fathers who had killed in a non-wounding way.
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Webb, Julian. "Inventing the good: A prospectus for clinical education and the teaching of legal ethics in England". Law Teacher 30, n.º 3 (janeiro de 1996): 270–94. http://dx.doi.org/10.1080/03069400.1996.9992956.
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Collinson, Robert, Alice Diver e Sharon McAvoy. "Clients, clinics and social justice". Higher Education, Skills and Work-Based Learning 8, n.º 3 (13 de agosto de 2018): 323–36. http://dx.doi.org/10.1108/heswbl-03-2018-0037.
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PurposeThe purpose of this paper is to present a case study of an innovative, three-module pathway designed by the Department of Law and Criminology at Edge Hill University (England) in 2014. In addition to supporting the work of its campus pro-bono law clinic, the first-two modules aim to enhance and evidence the legal skills of EHU’s undergraduate LLB students, to embed a deeper awareness of the (legal) ethics needed for sustainable legal practice (within PRME), and to highlight the increasing need for socially responsible advocates, able to defend the rights of marginalised, vulnerable clients.Design/methodology/approachThe critical analysis of the content and scope of an innovative, work-based learning LLB module pathway, which furthers the aim of the UN Global Compact and the PRME, and ties them firmly to socio-legal issues and advocacy involving recent jurisprudence.FindingsThe case law used within the modules, and the practical work of the students in the campus law clinic, are relevant to social justice issues and to the promotion of PRME values—they promote awareness of human rights principles, highlight the importance of access to legal services and provide students with knowledge of legal ethics. Enhanced employability skills flow from this.Research limitations/implicationsThis is a narrow case study but still provides a useful analysis of an innovative, PRME relevant module pathway. The model mirrors international trends in clinical legal education and also offers a template for other law schools keen to promote the concept of ethical, just legal practice.Practical implicationsThe paper posits that enhanced employability can flow from real world tasks such as advocacy for marginalised or disadvantaged groups and presents an exemplar for other law schools wishing to embed ethics/clinical law practice into their curriculum.Social implicationsThe paper highlights how the campus law clinic serves the public in a deprived region—it raises awareness of human rights and of social justice issues. It has the potential to feed into litigation on social welfare issues (housing, social security, child welfare, etc.).Originality/valueThe discussion of the human rights case law that is used in the Year 2 “bridging module” (which prepares students for working in the law clinic in their final year) is particularly relevant and is analysed in detail, highlighting how this module pathway is aimed at promoting PRME and UN Global Compact principles.
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Campbell, Elaine. "Regulating Clinic: Do UK Clinics Need to Become Alternative Business Structures Under the Legal Services Act 2007?" International Journal of Clinical Legal Education 20, n.º 1 (8 de julho de 2014): 519. http://dx.doi.org/10.19164/ijcle.v20i1.19.
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<p>In clinical legal education circles we tend to focus on the pedagogical aspects of our work. We enjoy lively debate on topics such as assessment, skills, ethics, student self-efficacy, the role of reflection and balancing the needs of the student with the needs of the client. Rarely do we speak or write about the legal framework regulating the work that occurs in clinics. However, the regulatory landscape is changing, and rapidly.</p><p>The Legal Services Act 2007 allows organisations that are owned or managed by non-lawyers to provide regulated legal services. It permits and encourages new entrants to the legal services market in England and Wales. It was heralded as ushering in important new opportunities for solicitors to team up with non-lawyers and to attract capital for their businesses in a carefully regulated environment. At first glance, there did not appear to be anything within the framework which affected law school clinics. On closer inspection, this is sadly not the case.</p><p><br />The aim of this paper is to increase the level of awareness within the clinical legal education community, in England and Wales in particular, of the effects of the Legal Services Act 2007 on clinical activity. It will explore the background to the introduction of alternative business structures and compare the approach which Australia has taken. It will also look to the future and discuss potential problems and solutions.</p>
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Moulton, Benjamin, e Jaime S. King. "Aligning Ethics with Medical Decision-Making: The Quest for Informed Patient Choice". Journal of Law, Medicine & Ethics 38, n.º 1 (2010): 85–97. http://dx.doi.org/10.1111/j.1748-720x.2010.00469.x.
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Medical practice should evolve alongside medical ethics. As our understanding of the ethical implications of physician-patient interactions becomes more nuanced, physicians should integrate those lessons into practice. As early as the 1930s, epidemiological studies began to identify that the rates of medical procedures varied significantly along geographic and socioeconomic lines. Dr. J. Alison Glover recognized that tonsillectomy rates in school children in certain school districts in England and Wales were in some cases eight times the rates of children in other districts, with the only significant predictive factors being the current chief medical officer in the area and the socioeconomic well-being of the child's parents. Unfortunately, Dr. Glover's work revealed that the increase in tonsillectomies did not improve the health of adolescent patients and appeared to be performed “as a routine prophylactic ritual for no particular reason and with no particular result.”
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Andoh, Benjamin. "The Informal Patient in England and Wales". Medicine, Science and the Law 40, n.º 2 (abril de 2000): 147–55. http://dx.doi.org/10.1177/002580240004000211.
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The informal status of a patient is a very important topic because the vast majority of mental patients in hospital are informal. The origins of the status are traced to the Royal Commissions of 1924–6 and 1954–7 which recommended voluntary admissions and informal admissions, respectively. It is pointed out, inter alia, that it is only generally true to say the informal patient has consented to admission and cannot be treated without his or her consent because exceptionally he or she can be given such treatment, e.g. on the grounds of necessity, as held by the House of Lords in R v Bournewood Community and Mental Health Trust (1998) and that today there are two types of informal patients: those who can, and do, consent to admission, and those who cannot consent to admission, but do not show willingness to leave hospital. It is argued that there is only a power under the Mental Health Act 1983 to admit patients informally. Finally, the informal patient's consent to admission, consent to treatment, other rights, leaving hospital, and how his or her position can be improved are looked at.
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Prins, Herschel. "Inquiries after Homicide in England and Wales". Medicine, Science and the Law 38, n.º 3 (julho de 1998): 211–20. http://dx.doi.org/10.1177/002580249803800306.
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Recent instruction from the Department of Health requires the institution of an independent inquiry into all cases of homicide committed by those who have been in contact with the psychiatric services. The background to this instruction is explored briefly within the context of more general concerns about violence and homicide, and the advantages and disadvantages of such inquiries are discussed.
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Hodson, Nathan. "A care ethics approach to the Gender Kidney Donation Gap". Nursing Ethics 26, n.º 7-8 (1 de novembro de 2018): 2185–94. http://dx.doi.org/10.1177/0969733018806337.
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Many studies have shown that women are more likely than men to be living kidney donors, and the discrepancy is particularly marked in heterosexual couples: wives are more likely than husbands to donate a kidney to their spouse. This ‘ Gender Kidney Donation Gap’ can be understood in terms of Carol Gilligan’s claims about gender differences in ethical decision-making style, making it appropriate to analyse responses to this imbalance using an ethic of care. This article centres the vast majority of living donors, those who donate in the context of a significant pre-existing relationship. A cost-neutral approach is unfair on donors who make society richer and healthier by helping a loved one. However, models of kidney sale fail to offer an acceptable alternative, either (a) compelling donors to sell into a pool where they do not know the recipient or (b) allowing affluent individuals unfair access to kidneys. Drawing on surrogacy law in England and Wales, a model of compensation is proposed that includes a range of non-financial benefits. This option celebrates donation and expresses gratitude to all donors while avoiding the pitfalls of the marketplace, with an emphasis on fair treatment of donors. Nevertheless, if more generous treatment led to a 10% increase in directed donation, then it would be equivalent to doubling ‘altruistic’ stranger donations. As long as the Gender Kidney Donation Gap persists, the best response is to minimise the discomfort and disruption caused to donors by their profound act of kindness.
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Brown, Penelope. "Unfitness to plead in England and Wales: Historical development and contemporary dilemmas". Medicine, Science and the Law 59, n.º 3 (15 de junho de 2019): 187–96. http://dx.doi.org/10.1177/0025802419856761.
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Fitness to plead refers to a criminal defendant’s ability to participate at trial. The purpose of fitness-to-plead laws is to protect the rights of vulnerable individuals who are unable to defend themselves in court and to preserve natural justice in the legal system while balancing the needs to see justice served and protection of the public. Early legal systems treated mentally disordered defendants with leniency, but over time those found unfit to plead have been subjected to indefinite incarceration, breaching their right to liberty while protecting their right to a fair trial. Conversely, the threshold for being found unfit is high, and there are concerns that many unfit defendants are being unfairly subjected to trial. The approaches to balancing the competing demands have changed over time and have led to confusing and contradictory practices. In order to understand better how and why the current problems have come to exist, this paper analyses the historical development of the legal framework for fitness to plead from Medieval England to the turn of the 21st century. It isolates core dilemmas: (a) what the normative standard of fitness to plead is and whether the current test for determining fitness adequately reflects this standard; (b) whether fitness to plead should be disability neutral or whether unfitness requires the presence of a psychiatric diagnosis; and (c) how the courts should deal with those found unfit to plead, including insuring against the deprivation of liberty of innocents while ensuring the public are adequately protected.
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Marks, M. N., e R. Kumar. "Infanticide in Scotland". Medicine, Science and the Law 36, n.º 4 (outubro de 1996): 299–305. http://dx.doi.org/10.1177/002580249603600405.
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Details from Scottish Office records of all infants under a year who were the victims of homicide in Scotland during 1978–1993 are presented and compared with results from studies of infant homicide in England and Wales. Although Scottish homicide rates in the total population are much higher than those in England and Wales, the annual Scottish infanticide rate (43/million) is remarkably similar to that of England and Wales (45/million). In addition, characteristics of victims and perpetrators are also similar between the two regions. As with England and Wales, in Scotland the younger the infant the greater the risk of becoming the victim of homicide (83% were killed within 6 months of birth); male babies were more frequently killed than female ones; a parent was the most frequent perpetrator (93% of offences); mothers tended to kill neonates but for infants older than a day more fathers than mothers were recorded as the main accused. Mothers and fathers were convicted of similar offences but fathers were less likely to receive non-custodial sentences. Differences in sentencing appeared to be related to either gender-related differences in attributions as to the motivation for the offence, or to the level of violence used against the victim. Offences of mothers were most frequently recorded as being motivated by mental illness, those by fathers as due to rage. Fathers were more likely to have killed by kicking or hitting, mothers by some form of suffocation.
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Stievano, Alessandro, Sue Bellass, Gennaro Rocco, Douglas Olsen, Laura Sabatino e Martin Johnson. "Nursing’s professional respect as experienced by hospital and community nurses". Nursing Ethics 25, n.º 5 (12 de setembro de 2016): 665–83. http://dx.doi.org/10.1177/0969733016664972.
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Background: There is growing awareness that patient care suffers when nurses are not respected. Therefore, to improve outcomes for patients, it is crucial that nurses operate in a moral work environment that involves both recognition respect, a form of respect that ought to be accorded to every single person, and appraisal respect, a recognition of the relative and contingent value of respect modulated by the relationships of the healthcare professionals in a determined context. Research question/aim: The purpose of this study was to develop better understandings of perceptions of nursing’s professional respect in community and hospital settings in England. Research design: The research design was qualitative. Focus groups were chosen as the most appropriate method for eliciting discussion about nursing’s professional respect. Participants and research context: A total of 62 nurses who had been qualified for at least a year and were working in two localities in England participated in this study. Methods: Data were collected using 11 focus group sessions. The data were analysed by means of an inductive content analysis, extracting meaning units from the information retrieved and classifying the arising phenomena into conceptually meaningful categories and themes. Ethical considerations: To conduct the research, permission was obtained from the selected universities. Results: Recognition respect of human beings was perceived as ingrained in the innermost part of nurses. Regarding appraisal respect, a great importance was placed on: the interactions among healthcare professionals, the time to build trust in these relationships, the influences of the workplace characteristics and nurses’ professional autonomy and decision-making. Conclusion: Recognition respect of persons was embedded in the inmost part of nurses as individuals. Concerning appraisal respect, it was thought to be deeply enshrined in the inter- and intra-healthcare professional interactions. The forging of trusting relationships over time was deemed to be strongly associated with good quality interactions with other healthcare professionals.
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Cameron, J. M. "Book Review: Coroners' Records in England and Wales". Medicine, Science and the Law 28, n.º 4 (outubro de 1988): 344–45. http://dx.doi.org/10.1177/002580248802800418.
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Nowers, M. "Gunshot Suicide in the County of Avon, England". Medicine, Science and the Law 34, n.º 2 (abril de 1994): 95–98. http://dx.doi.org/10.1177/002580249403400202.
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A study of 51 consecutive gunshot suicides in the County of Avon, England, between 1974 and 1990 is presented. All cases were male. The majority were married and lived with their spouses. Most suicides occurred in the setting of a domestic dispute, although at least nine had a significant past psychiatric history. Possible implications of firearm legislation and psychiatric treatment on firearm suicide rates are discussed.
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Gibbons, Susan MC. "Are UK genetic databases governed adequately? A comparative legal analysis". Legal Studies 27, n.º 2 (junho de 2007): 312–42. http://dx.doi.org/10.1111/j.1748-121x.2007.00045.x.
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Given the burgeoning of genetic research and proliferation of human genetic databases, especially in the biomedical sphere, this paper explores whether the existing laws and regulatory structures for governing genetic databases in England and Wales are adequate. Through a critical survey of relevant rules, bodies and practices, it argues that the current UK framework is far from ideal in at least five major areas: (1) forms and styles of law used, especially the separate legislative regimes for physical biomaterial and data; (2) core definitions; (3) formal regulatory bodies, licensing and notification requirements; (4) ethics committees and other advisory panels; and (5) enforcement powers and sanctions. Such shortcomings could have major implications for stakeholders, hamper efforts to achieve European or international harmonisation of genetic database principles and practices, and undermine the UK’s standing as a world leader in genetics and biotechnology. Drawing on comparative analysis of governance strategies adopted in Estonia, Iceland and Sweden, the paper identifies alternative options and lessons from experiences abroad, suggesting possible avenues for reform that may warrant serious consideration in the UK.
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Kong, Camillia. "The Phenomenology and Ethics of P-Centricity in Mental Capacity Law". Law and Philosophy 42, n.º 2 (9 de março de 2023): 145–75. http://dx.doi.org/10.1007/s10982-022-09458-6.
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AbstractUnder the Mental Capacity Act 2005 (MCA) in England and Wales, the liberal commitments to subjective freedom guide obligations towards persons who do not lack capacity. For the subject of proceedings who might lack capacity (P), it is less clear as to what obligations orient best interests decision-making on their behalf. The UK Supreme Court has emphasised the centrality of ‘P-centricity’ in best interests decision-making, where there is the legal obligation to consider P’s subjective views and wishes in a holistic consideration of best interests. Unclarity nonetheless persists as to what is owed to P in the best interests standard, leading to the tendency to interpret obligations of P-centricity through the normative prism of subjective autonomy. This paper argues that such moves reduce the complex moral phenomenology of what a P-centric ethos entails. Instead, the phenomenological and ethical stance of moral considerability and recognition respect can best capture the enriched normative grounding for P-centric decision-making in mental capacity law.
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Neades, Barbara L. "Presumed Consent to Organ Donation in Three European Countries". Nursing Ethics 16, n.º 3 (maio de 2009): 267–82. http://dx.doi.org/10.1177/0969733009102687.
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United Kingdom Transplant reported that, during 2007—2008, a total of 7655 people were awaiting a transplant; however, only 3235 organs were available via the current `opt in' approach. To address this shortfall, new UK legislation sought to increase the number of organs available for donation. The Chief Medical Officer for England and Wales supports the adoption of `presumed consent' legislation, that is, an `opt out' approach, as used in much of Europe. Little research, however, has explored the impact on bereaved relatives, nurses and medical staff of introducing presumed consent legislation. Adopting a phenomenological approach, this study used responses to an initial questionnaire combined with selected interviews with health care professionals to capture their direct experience of presumed consent legislation in three European countries: Portugal, Norway and Belgium.
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Rubio-Navarro, Alfonso, Diego José García-Capilla, Maria José Torralba-Madrid e Jane Rutty. "Decision-making in an emergency department: A nursing accountability model". Nursing Ethics 27, n.º 2 (18 de julho de 2019): 567–86. http://dx.doi.org/10.1177/0969733019851542.
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Introduction: Nurses who work in an emergency department regularly care for acute patients in a fast-paced environment, being at risk of suffering high levels of burnout. This situation makes them especially vulnerable to be accountable for decisions they did not have time to consider or have been pressured into. Research objective: The objective of this study was to find which factors influence ethical, legal and professional accountability in nursing practice in an emergency department. Research design: Data were analysed, codified and triangulated using qualitative ethnographic content analysis. Participants and research context: This research is set in a large emergency department in the Midlands area of England. Data were collected from 186 nurses using participant observation, 34 semi-structured interviews with nurses and ethical analysis of 54 applicable clinical policies. Ethical considerations: Ethical approval was granted by two research ethics committees and the National Health Service Health Research Authority. Results: The main result was the clinical nursing accountability cycle model, which showed accountability as a subjective concept that flows between the nurse and the healthcare institution. Moreover, the relations among the clinical nursing accountability factors are also analysed to understand which factors affect decision-making. Discussion: The retrospective understanding of the factors that regulate nursing accountability is essential to promote that both the nurse and the healthcare institution take responsibility not only for the direct consequences of their actions but also for the indirect consequences derived from previous decisions. Conclusion: The decision-making process and the accountability linked to it are affected by several factors that represent the holistic nature of both entities, which are organised and interconnected in a complex grid. This pragmatic interpretation of nursing accountability allows the nurse to comprehend how their decisions are affected, while the healthcare institution could act proactively to avoid any problems before they happen.
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Aveyard, Helen. "Informed Consent Prior to Nursing Care Procedures". Nursing Ethics 12, n.º 1 (janeiro de 2005): 19–29. http://dx.doi.org/10.1191/0969733005ne755oa.
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It is largely undisputed that nurses should obtain consent prior to nursing care procedures. This article reports on a qualitative study examining the way in which nurses obtain such informed consent. Data were collected through focus group discussion and by using a critical incident technique in order to explore the way in which nurses approach consent prior to nursing care procedures. Qualified nurses in two teaching hospitals in England participated in the study. An analysis of the data provides evidence that consent was often not obtained by those who participated in the study and that refusals of care were often ignored. In addition, participants were often uncertain how to proceed with care when the patient was unable to consent. Consent prior to nursing care procedures is an essential but undeveloped concept, for which a new ethos is required.
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White, Elizabeth. "A Comparison of Nursing Education and Workforce Planning Initiatives in the United States and England". Policy, Politics, & Nursing Practice 18, n.º 4 (novembro de 2017): 173–85. http://dx.doi.org/10.1177/1527154418759666.
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Health care systems in England and the United States are under similar pressures to provide higher quality, more efficient care in the face of aging populations, increasing care complexity, and rising costs. In 2010 and 2011, major strategic reports were published in the two countries with recommendations for how to strengthen their respective nursing workforces to address these challenges. In England, it was the 2010 report of the Prime Minister’s Commission on the Future of Nursing and Midwifery, Front Line Care: The Future of Nursing and Midwifery in England. In the United States, it was the Institute of Medicine’s report The Future of Nursing: Leading Change, Advancing Health. The authors of both reports recommended shifting entry level nursing education to the baccalaureate degree and building capacity within their educational systems to prepare nurses as leaders, educators, and researchers. This article will explore how, with contrasting degrees of success, the nursing education systems in the United States and England have responded to these recommendations and examine how different regulatory and funding structures have hindered or enabled these efforts.
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Madhloom, Omar. "Unregulated Immigration Law Clinics and Kant’s Cosmopolitan Right: Challenging The Political Status Quo". International Journal of Clinical Legal Education 28, n.º 1 (22 de abril de 2021): 195–243. http://dx.doi.org/10.19164/ijcle.v28i1.1131.
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Unregulated law clinics in England and Wales are prohibited from directly offering immigration advice and assistance. This article argues that this restriction should not be a barrier to teaching immigration law. Kant’s duty-based ethics and his cosmopolitan right can provide a useful normative framework for challenging the political status quo in relation to the regulation of law clinics and policies affecting migrants. It is argued that introducing normative values into Clinical Legal Education can address the limitations of the conventional ‘hired-gun’ model and engender students to a more holistic approach to lawyering. In other words, a model which promotes the causes of third parties.
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Rehmann-Sutter, Christoph, e Lynn Hagger. "Organised Assistance to Suicide in England?" Health Care Analysis 21, n.º 2 (8 de setembro de 2011): 85–104. http://dx.doi.org/10.1007/s10728-011-0191-y.
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Leadbetter, Martin J. "Fingerprint Evidence in England and Wales – The Revised Standard". Medicine, Science and the Law 45, n.º 1 (janeiro de 2005): 1–6. http://dx.doi.org/10.1258/rsmmsl.45.1.1.
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Calveley (née Clark), Julie. "Including adults with intellectual disabilities who lack capacity to consent in research". Nursing Ethics 19, n.º 4 (29 de junho de 2012): 558–67. http://dx.doi.org/10.1177/0969733011426818.
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The Mental Capacity Act 2005 has stipulated that in England and Wales the ethical implications of carrying out research with people who are unable to consent must be considered alongside the ethical implications of excluding them from research altogether. This paper describes the methods that were used to enable people with severe and profound intellectual disabilities, who lacked capacity, to participate in a study that examined their experience of receiving intimate care. The safeguards that were put in place to protect the rights and well-being of participants are described, and it is argued that the approaches used in this study met the requirements set out in the Mental Capacity Act 2005. Although this paper is based on research involving people with intellectual disabilities, it has implications for research involving other groups who may also lack capacity to consent, including people with mental health problems, head injuries and dementia.
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Curtis, Katherine. "Learning the requirements for compassionate practice". Nursing Ethics 21, n.º 2 (20 de março de 2013): 210–23. http://dx.doi.org/10.1177/0969733013478307.
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Student nurses’ professional development arises through socialisation in nursing knowledge, values and behaviours. Students are expected to demonstrate compassion; however, compassion is a complex concept, one that creates emotional challenges. A grounded theory study was undertaken to explore student nurse socialisation in compassionate practice. In-depth interviews were undertaken with 19 students in the north of England during 2009–2010, and their concerns and concern management emerged. Students expressed several concerns, one being their emotional vulnerability and uncertainty of the emotional requirements for compassionate practice. A core category of ‘balancing future intentions’ was identified: that students managed feelings of vulnerability and uncertainty through balancing their intentions towards and away from engagement in compassionate practice, depending upon perceived impact on their emotional well-being. The findings are discussed in relation to emotional labour and moral distress, and courage, resilience and self-compassion are explored as a means to enable sustainable compassionate practice.
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Kahn, Jeffrey. "Commentary: Making the Most of Strangers' Altruism". Journal of Law, Medicine & Ethics 30, n.º 3 (2002): 446–47. http://dx.doi.org/10.1111/j.1748-720x.2002.tb00413.x.
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Lainie Ross, in her article in this issue, criticizes on ethical grounds a number of factors in the University of Minnesota program that allows unrelated strangers to donate kidneys for transplant. I have to admit that when the transplant center at the University proposed allowing the practice of what came to be called nondirected donation, I was skeptical about a number of the same issues that trouble Dr. Ross. But as my colleagues and I examined and discussed the ethics of such a plan, along with the risks to prospective donors, their possible motivations, and the logistics of performing the surgeries under conditions of anonymity between donor and recipient, among other factors, we came to believe that such donations can be ethically acceptable. As a product of frequent meetings over the course of a year in advance of the first nondirected donation, we set out to craft a process that would first and foremost meet the test of an ethical approach to organ donation and transplant, the description of which was published in the New England Journal of Medicine in August 2000.
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McKenzie, Karen, Suzanne Taylor, George Murray e Ian James. "The use of therapeutic untruths by learning disability nursing students". Nursing Ethics 27, n.º 8 (6 de julho de 2020): 1607–17. http://dx.doi.org/10.1177/0969733020928130.
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Background: The use of therapeutic untruths raises a number of ethical issues, which have begun to be explored to some extent, particularly in dementia care services, where their use has been found to be high. Little is known, however, about their use by health professionals working in learning disability services. Research question: The study aimed to explore the frequency of use of therapeutic untruths by student learning disability nurses, and by their colleagues; how effective the students perceived them to be as a means of responding to behaviours that challenge; and their level of comfort with using them. Research design: A correlational design was used to gather data from an online version of the Best Interest Scale, adapted for a learning disability context. Participants were 30 learning disability student nurses (female = 28, ages 18–48 years, M = 26.8, standard deviation = 7.3) studying at a university in the North-East of England. Ethical considerations: The study was reviewed and received ethical approval from the first author’s university ethics committee. Findings: Overall, 96% of participants reported using therapeutic untruths. ‘Omission’ was the most frequently used type of therapeutic untruths, the most effective and the type that the students felt most comfortable using. Frequency of use of therapeutic untruths correlated significantly and positively with perceived effectiveness and the level of comfort that the students felt when using them, for all types of therapeutic untruths. Conclusion: The use of therapeutic untruths by the student nurses was consistent with that found in research in dementia care services in the United Kingdom and abroad. Further research to explore the generalisability of the results to the wider context of learning disability services is needed. The study highlights that there may be a need for more formal guidance and educational input to student nurses in the use of therapeutic untruths with people with a learning disability.
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Black, Sharon, Joan Curzio e Louise Terry. "Failing a student nurse". Nursing Ethics 21, n.º 2 (28 de agosto de 2013): 224–38. http://dx.doi.org/10.1177/0969733013495224.
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The factors preventing registered nurses from failing students in practice are multifaceted and have attracted much debate over recent years. However, writers rarely focus on what is needed to fail an incompetent pre-registration nursing student in their final placement. This hermeneutic study explored the mentor experience of failing a pre-registration nursing student in their final placement. A total of 19 mentors were recruited from 7 different healthcare organisations in both inner city and rural locations in the southeast of England. Participants took part in individual reflective interviews about their experience of failing a pre-registration nursing student in their final placement. These experiences were interpreted through a hermeneutic discovery of meaning. The new horizon of understanding which developed as a result of this research is framed within the context of moral stress, moral integrity and moral residue with the overall synthesis being that these mentors’ stories presented a new horizon of moral courage.
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Simillis, Constantinos. "Euthanasia: a summary of the law in England and Wales". Medicine, Science and the Law 48, n.º 3 (julho de 2008): 191–98. http://dx.doi.org/10.1258/rsmmsl.48.3.191.
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Thomas, Stuart D. M., Mairead Dolan, Jenny Shaw, Samantha Thomas, Graham Thornicroft e Morven Leese. "Redeveloping Secure Psychiatric Services for Women". Medicine, Science and the Law 45, n.º 4 (outubro de 2005): 331–39. http://dx.doi.org/10.1258/rsmmsl.45.4.331.
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Historically, a substantial proportion of women have been unduly detained in conditions of high security in England due to the lack of suitable alternative facilities. There have been no studies that have comprehensively examined the individual needs of these women in relation to their placement needs. A cross sectional survey was undertaken of the individual and placement needs of all females detained in the three high security psychiatric hospitals (HSPHs) in England on 18th October 1999. Whilst there are clearly differences in accommodation needs among the women, those requiring lower secure services are significantly less likely to have needs in relation to violence (OR 0.29, 95% CI 0.14-0.62) and drugs (OR 0.29, 95% CI 0.12-0.67) when length of stay is taken into account. They also have lower security, treatment and dependency needs than women still requiring HSPH treatment. A significant reorganisation of services is required. There is a need to gain further understanding of the relationships between traumatic histories, clinical presentation and antisocial behaviour and how these impact on assessed risk, treatment and care needs and outcome. The special needs of these women should be considered a priority when developing treatment and care packages.
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Strand, Nicolle K. "Racial Myths and Regulatory Responsibility". Journal of Law, Medicine & Ethics 49, n.º 2 (2021): 231–40. http://dx.doi.org/10.1017/jme.2021.33.
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AbstractCalls to abolish race as a proxy for biology or genetics in clinical care have reached a fever pitch in the latter half of 2020, including articles in the New England Journal of Medicine, and urgent letters from prominent Senators.
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Lester, David. "Are Murders and Suicides Committed by Different Methods Intrinsically Different?" Medicine, Science and the Law 36, n.º 1 (janeiro de 1996): 28–30. http://dx.doi.org/10.1177/002580249603600106.
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A time-series study of homicide and suicide rates by each method in England and Wales from 1950 to 1985 showed that the sociological correlates of these rates depended upon the method used for killing. This raises the possibility that murder and suicide may not be unitary phenomena, but rather that murder and suicide by particular methods are distinct deviant acts and should be studied separately.
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Greenberg, Neil, Keith Lloyd, Chris O'Brien, Sian McIver, Amanda Hessford e Martin Donovan. "A Prospective Survey of Section 136 in Rural England (Devon and Cornwall)". Medicine, Science and the Law 42, n.º 2 (abril de 2002): 129–34. http://dx.doi.org/10.1177/002580240204200203.
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Coid, Jeremy, Paul Bebbington, Rachel Jenkins, Traolach Brugha, Glyn Lewis, Michael Farrell e Nicola Singleton. "The National Survey of Psychiatric Morbidity among Prisoners and the Future of Prison Healthcare". Medicine, Science and the Law 42, n.º 3 (julho de 2002): 245–50. http://dx.doi.org/10.1177/002580240204200309.
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It has long been known that psychiatric disorders are highly prevalent among prisoners (Coid, 1984; Gunn et al., 1991; Maden et al., 1995; Joukamaa, 1995; Bland et al., 1998; Lamb and Weinberger, 1998). However, the Survey of Psychiatric Morbidity Among Prisoners in England and Wales (Singleton et al., 1998) represents a considerable advance on earlier surveys. By using the same standardized psychiatric assessment procedures, and similar questions on medication, service use and social functioning, its findings can be compared with previous national surveys of adults living in private households (Meltzer et al., 1995), residents in institutions (Meltzer et al., 1996), homeless persons (Gill et al., 1996), and with the forthcoming household survey in England, Wales and Scotland. It should also inform the future organisation of healthcare for prisoners, following recent recommendations from a joint Home Office/Department of Health Working Party that Health Authorities must work with prisons in their catchment areas to carry out joint health needs assessments, agree prison healthcare improvement strategies and jointly plan and commission services (HM Prison Service and NHS Executive 1999). The ultimate test of the survey will be whether it provides a benchmark to evaluate the future effectiveness of the new policy changes.
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Cantrell, Tobias K. "The ‘opt-out’ approach to deceased organ donation in England: A misconceived policy which may precipitate moral harm". Clinical Ethics 14, n.º 2 (junho de 2019): 63–69. http://dx.doi.org/10.1177/1477750919851052.
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In an effort to solve the shortage of transplantable organs, there have been several proposals to introduce an opt-out approach to deceased organ donation in England (also termed ‘deemed’, or ‘presumed’ consent). In seeking to enact the so-called ‘opt-out proposal’ via an amendment to the Human Tissue Act 2004, The Organ Donation (Deemed Consent) Bill 2017–19 represents the most recent attempt at such legal reform. Despite popular calls to the contrary, I argue in this paper that it would be premature for England, or, indeed, any country, to adopt an opt-out approach at this time. Not only is the available evidence inconclusive on whether introduction of the opt-out proposal would increase the supply of transplantable organs (a common misconception), but there is also a chance that doing so might bring about an otherwise avoidable moral harm through an unjustified interference with individual autonomy. I maintain that the resources required to change the law to such effect would be better expended on alternative, provenly efficacious and less contentious mechanisms for increasing the supply of transplantable organs, such as: improving communication with the family of the deceased, developing infrastructure, raising public awareness and enhancing staff training, attitudes and understanding towards organ donation.
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Hallett, Nicholas. "To what extent should expert psychiatric witnesses comment on criminal culpability?" Medicine, Science and the Law 60, n.º 1 (4 de setembro de 2019): 67–74. http://dx.doi.org/10.1177/0025802419872844.
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Following the Court of Appeal case of R v Edwards in England and Wales, there has been increasing pressure for expert psychiatric witnesses to comment explicitly on how a defendant’s mental disorder affects their culpability. Culpability is the degree to which a person can be held morally or legally responsible for their conduct, but defining culpability has proved difficult. Mental disorder does not translate easily into degrees of legal culpability. Although psychiatric evidence will often be central to such cases, the determination of culpability is a matter for the court, and experts should not comment on it explicitly. Nevertheless, certain areas of psychiatry may have a bearing on culpability, and ways in which experts may comment on these are suggested. Given the pressure on judges to determine culpability, experts need to be honest about the limits of medical science to answer legal questions and the professional necessity to remain within their area of expertise.