Law and Medical Ethics

The course consists of ten modules.

1. Introduction to Law and Medical Ethics

   The interface between law, medicine and ethics is a subject of great contemporary interest and relevance and new developments in medical practice and research are constantly in the headlines.

   Advances in knowledge create new challenges, on an almost weekly basis, that lawyers, judges, medical professionals and members of the public find themselves struggling to address.

   The aim of this module is to explore the critical relationship between the law, and the practice of medicine, in order to set the groundwork for discussions in the more topic-specific modules. In doing so, it will focus on the varied approaches to, and multi-layered interrelationships among, ethics, medicine and law, including basic ethical principles and key (legal) concepts relating to, among others, personhood, autonomy, human rights, sanctity of life, and quality of life.

2. Consent to Medical Treatment

   Consent is the single most pivotal issue in contemporary medical jurisprudence, and the most obvious example of the centrality of patient autonomy, both in practice and in law.

   This module looks at the variety of conditions, criteria and limitations relating to consent, including the different 'levels' of consent, what 'valid consent' requires, the implications of proceeding without it, and how these differ, depending on the 'type' of patient, or circumstance. In each of these contexts, the module investigates whether questions of consent are absolute or subject to limitations, and issues that arise in the application of principles to practical circumstances.

3. Refusal of Medical Treatment

   That patients exercise 'rights' to autonomy when providing consent only makes sense if there is a corresponding right to refuse, and so this module considers the nature and scope of the right to refuse or withdraw consent to medical treatment.

   We will explore whether the right is subject to limitations, and specific criteria that apply. Mirroring the module on positive consent, a thorough understanding of refusal encompasses many of the same 'categories' of patient encountered in the previous session.

   A key question to consider during this module is whether consent and refusal are two sides of the same coin? If so, does it mean that the criteria and principles applied to the former must be applied with equal weight and effect to the latter? In logic, there is no difference in the 'ability' to either consent or refuse. In law, however, we find that the two aspects are often treated distinctly, with higher thresholds being required by the courts in relation to refusals.

4. Withholding and Withdrawing Care

   This module examines 'medical futility' and the 'duty to prolong life' in respect of patients with terminal conditions, or in a prolonged disorder of consciousness - like the permanent vegetative state (PVS) - and the complex issues surrounding euthanasia and physician assisted suicide (PAS).

   The clash of values which arises when a medical assessment is countered by a patient's wishes is explored, as are the difficulties inherent in the 'sea-change' brought about by the subtle but significant shift in the role of health care professional from 'life saver' to 'quality of life provider'.

   Euthanasia, in particular, is a subject about which a lot has been written, yet a great deal of confusion still characterises the debate, at least in part due to misapprehensions and unclear definitions. The terminology, and treatment of different classifications are of critical legal and ethical significance, drawing an important line between assisting a 'peaceful death', and 'painless killing', which have considerably different consequences for medical practitioners.

5. Medical Negligence

   The law of tort (or personal injury), is a complex area of the common law, where rules abound and exceptions seem endless.

   This module focuses on the role of the law of negligence in the medical context, essentially as a means of providing compensation to patients who have suffered a 'legally-recognised harm'. The criteria for a 'successful' negligence action will be considered, as well as the availability of different defences.

   In an action in negligence the patient is required to bear the burden of proving a substantial number of fundamental elements, including who is liable, the existence of a duty of care, the establishment in law of a 'causative' fault, and the relevant standard by which a breach of duty should be judged. In many cases, the volume and quality of information provided to a patient, and how it affected their ability to consent, is a major and determining factor.

6. Patient Confidentiality

   The Hippocratic Oath requires that medical practitioners bind themselves in the following manner: "[a]ll that may come to my knowledge in the exercise of my profession or outside of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and never reveal."

   Today, most medical schools no longer require students to take the traditional Oath, yet the idea of treating patient health information as secret is generally accepted as a fundamental ethical principle underpinning the doctor/patient relationship. In the United Kingdom, the General Medical Council undertook a comprehensive review of its guidance on patient confidentiality and this is as strong an indication as any of how important the issue is in the medico-legal world.

   In this module, we examine the principles that form the content of the duty of confidentiality, when the duty arises, the circumstances which constitute exceptions, and indeed whether there can be a duty to breach confidentiality. Consideration of the tensions between 'rules intended to protect patient privacy', on the one hand, and new obligations arising from freedom of information legislation, on the other, will form a key part in the discussions.

7. Human Rights and Medical Practice

   Over the years there have been significant additions to the statutory control of the health care professions, including the Health Act1999, the National Health Service Reform and Health Care Professions Act 2002, the Health and Social Care Act 2008, and the Health and care Act 2022.

   One of the most remarkable aspects of this statutory reform is that the government is now able to make changes to the regulation of the health care professions by issuing Orders in Council, as opposed to negotiating the more public legislative processes inherent in the passage of Acts of Parliament.

   In this module, we look at reasons why this legislative programme has come about, issues of access to health care, and the role of human rights. Discussions will focus on regulatory and legislative controls that are more or less specific to the medical profession, including relevant provisions of the Human Rights Act 1998, and an assessment of their effect on medical practice. This module also considers how approaches to funding affect the availability of treatment, and how questions of access are interpreted and enforced for EU citizens in light of EU law.

8. Research and Ethical Approval

   For most of its history, biomedical research has been conducted in a relatively unregulated environment, with research justified solely on the basis that the activity ultimately benefits mankind.

   Research subjects often felt obliged to participate, with little or no hope of personal benefit. In this module, we will look at how attitudes, conditions, standards and safeguards have developed and changed over the last hundred years, including the emergence of substantial human rights protections, and protocols for protecting 'vulnerable' patient-subjects.

   Today, modern medical research is guided by a literal profusion of codes of practice, professional association and research committee guidelines, international protocols and national legislation. Research purposes, effectiveness and methods now have to be stringently justified, subject to broad principles and high standards of good clinical practice.

9. Mental Capacity and Mental Health

   The guiding pieces of legislation in the fields of mental capacity and mental health are contained in the Mental Capacity Act 2005 and the Mental Health Act 2007 (both effective in England and Wales) and the Mental Health (Care and Treatment) (Scotland) Act 2003 and the Adults with Incapacity (Scotland) Act 2000. This session provides an appreciation for the similarities and differences between the statutes, an understanding the legislative regimes, and their effect on fundamental elements of medical practice. It will be critically important for anyone dealing with the treatment of patients lacking the capacity to provide a valid consent for themselves.

   Alongside general issues of mental health law, two particularly significant areas of relevance to the medical profession that arise from the legislation will be explored in this module: the manner in which the law provides for consent to be given (or withheld) for proposed medical treatment of 'incompetent' patients by third parties (substitute decision-makers); and the effect that the legal recognition of 'advance directives' might have on the decision making and discretionary 'powers' of medical practitioners.

10. Genetics, Reproduction and the Law

    Genetics is a fast moving area of medical and scientific research, the results from which are challenging our ideas about who we are, and the roles that science and medicine can, should and will play in our lives.

    The availability of genetic information and diagnosis, as a consequence of the advances in genetic research and testing, have wide ranging implications, including issues for individual patients, and by extension, their genetically-related family members.

    In this module, various approaches to assisted reproduction are explored, as are the 'reproductive torts' - forms of negligence action related to issues of reproductive counselling. The material also provides an overview of the basic structure and nature of the Human Fertilisation and Embryology Act 2008, and the revised powers and procedures relating to assisted reproduction that are vested in the Human Fertilisation and Embryology Authority. We will also be looking into issues like surrogacy – commercial or otherwise – and the genetics issues that arise in reproduction and the law.

This programme of modules is designed to be taken online on a 'self-access' basis. This means that you can access course materials whenever you like, and work through the materials at your own pace.

You can log in to the course 24/7, so you can fit your learning around work and personal commitments.

Each module contains interactive quiz material, providing feedback so that you can check your progress and deepen your understanding. These quizzes can be taken as often as wished so that you can revisit specific areas of interest if desired.

To further aid your practice, each module has a ‘Take-home Toolkit’ which is a document that you can print off or download for future reference.

Each module should take between 5 and 10 hours to complete and you will have two weeks to complete each module. This allows you to go back through each module and concentrate on particular topics.

Certificate

After completing your module(s) please contact our online learning team who will be able to issue you with an e-certificate of completion on evidence that you have successfully completed all of the interactive quizzes for the modules which you have registered for.

Professional accreditation bodies may impose requirements over and above those of the School of Law.

This course can be taken at any time and is offered throughout the year.

You can book a single module or variety of modules depending on your interests. We offer discounted fees for 7 and 10 module bookings.

• Single module: £115
  You will have two weeks access for each module you book.
• Seven modules: £645 (Includes free ebook of Mason and McCall-Smith's Law and Medical Ethics)
  You will have 14 weeks access to your modules.
• Ten modules: course £920 (Includes free ebook of Mason and McCall-Smith's Law and Medical Ethics)
  You will have 20 weeks access to your modules.

Book online

You can book and pay online using the University's online store, ePay, or request to pay by invoice.

Paying by invoice

If you would like to be invoiced for the course fees please contact us. Please note we can only invoice for seven and ten module bookings.