Health "Brexternalities": The Brexit Effect on Health and Health Care outside the United Kingdom.

The principal effects of Brexit on health and health care will fall within the United Kingdom, and all forms of Brexit have overwhelmingly negative implications for health care and health within the UK. This article focuses on the external effects of Brexit ("Brexternalities") for health and health care. The EU is a particularly powerful institutional and legal arrangement for managing economic and political externalities in health policy as in any other policy.

Whistleblowing over patient safety and care quality: a review of the literature.

Purpose: The purpose of this paper is to review existing research on whistleblowing in healthcare in order to develop an evidence base for policy and research.

Design/methodology/approach: A narrative review, based on systematic literature protocols developed within the management field.

Findings: The authors identify valuable insights on the factors that influence healthcare whistleblowing, and how organizations respond, but also substantial gaps in the coverage of the literature, which is overly focused on nursing, has been largely carried out in the UK and Australia, and concentrates on the earlier stages of the whistleblowing process.

Healthcare scandals and the failings of doctors.

Purpose: The purpose of this paper is to explore whether official inquiries are an effective method for holding the medical profession to account for failings in the quality and safety of care.

Design/methodology/approach: Through a review of the theoretical literature on professions and documentary analysis of key public inquiry documents and reports in the UK National Health Service (NHS) the authors examine how the misconduct of doctors can be understood using the metaphor of professional wrongdoing as a product of bad apples, bad barrels or bad cellars.

Findings: The wrongdoing literature tends to present an uncritical assumption of increasing sophistication in analysis, as the focus moves from bad apples (individuals) to bad barrels (organisations) and more latterly to bad cellars (the wider system).

Innovation, informed consent, health research and the Supreme Court: Montgomery v Lanarkshire - a brave new world?

The Supreme Court decision in Montgomery v Lanarkshire ([2015] UKSC11) has been hailed as a landmark not least because the Court enshrines the doctrine of informed consent formally into English law for the first time in relation to medical treatment. This paper explores the decision in Montgomery. It examines what its implications may be in the future for the consent process in relation to health research and innovative treatment and whether it may prove a watershed moment leading to changing dialogues and expectations in relation to consent.

Reforming the EU Clinical Trials Directive: streamlining processes or a radical "new" agenda?

From its conception the EU Clinical Trials Directive met with controversy. Some saw it as an unnecessary inhibitor to scientific research, introducing bureaucracy which was unduly expensive, slowing down the clinical trial approval system. The Directive however also enshrined respect for fundamental rights in relation to clinical trials decision-making and impacted upon the domestic law of member states facilitating the alignment of trial review processes.

Faith, belief, fundamental rights and delivering health care in a modern NHS: an unrealistic aspiration?

This paper considers the way in which English law safeguards fundamental rights to respect for faith and belief in relation to the delivery of health care. It explores the implications of the Human Rights Act 1998 and the Equality Act 2010. It explores some of the challenges in attempting to reconcile fundamental rights to faith and belief and the delivery of health care, both now and in the future and whether this is a realistic aspiration in a state funded health care service.

Exploring patients' rights: what does the NHS Constitution tell us?

On 8 March 2012, the NHS published the latest version of its Constitution. In this article, the author explores the background of the debate regarding patients' rights and entitlements in the NHS. The author also discusses the provisions of the NHS Constitution, noting that it is largely a statement of existing principles, rather than a bold statement of rights.

The ageing population: is it time for an international convention of rights?

An increasing ageing population gives rise to many challenges for healthcare delivery. The need to ensure that there is respect for the rights and the dignity of older patients has been a consistent theme over the last decade. However, the vulnerability of this group of patients was highlighted again recently in a highly critical Health Service Commissioners Report.

Regulating cosmetic surgery: a scalpel where it is needed.

This paper considers the recent controversies around the regulation of cosmetic surgery procedures. The author suggests that any review considering reform of the law in this area should not only look at issues concerning the safety of the procedures and competence of the practitioners, but should also address the question of which procedures should be allowed. In particular, the author advocates that there should be a review as to the whether cosmetic procedures should be made available to those under the age of 18 years.

Sex selection and abortion: a case for legal re-evaluation?

This question of sex selection and abortion in the UK was highlighted by recent reports in a national newspaper. This paper explores the current legal position and whether there is a case for reforming the law to align the situation of abortion with that of sex selection in the context of pre-implantation genetic diagnosis.

Welsh Government proposals: organ and tissue donation reforms.

In November 2011, the Welsh Government published a consultation document setting out proposals for legislation on organ and tissue donation. The scheme would introduce a notable change in the law from a consent-based 'opt-in' scheme for transplantation to an 'opt-out' one. This article explores the scope of the current law concerning organ transplantation.

Using anonymized NHS data without consent: a step too far?

On 5 December 2011, the Government announced that NHS data will be made more widely available to researchers (BBC News, 2011). David Cameron suggested that 'everyone was to be a research patient' (BBC News, 2011) with anonymized NHS patient data being opened up to researchers in the private sector as well as the NHS. The proposals envisaged that all such data is opened up to researchers unless patients opt out.

A right to die or a right to live? Discontinuing medical treatment.

This article explores the decision in the case of W v M, S and an NHS Primary Care Trust [2011] EWHC 2443 (Fam) in which an application to withdraw feeding from a woman in a minimally conscious state was rejected by Baker J in the Court of Protection. The article places the case in the context of the development of case law concerning the withdrawal of treatment from patients lacking decision-making capacity, where death will be the inevitable consequence of the withdrawal of treatment after the decision in Airedale NHS Trust v Bland. It questions whether nearly two decades after the Bland decision there is scope for the boundaries of the decision to withdraw treatment from patients in 'futile' conditions to be reconsidered by the Supreme Court.

Accountability, governance and biobanks: the ethics and governance committee as guardian or as toothless tiger?

The huge potential of biobanks/genetic databases for the research community has been recognised across jurisdictions in both publicly funded and commercial sectors. But although there is tremendous potential there are likewise potential difficulties. The long-term storage of personal health information and samples poses major challenges.

NHS resource allocation: a question of funding?

The article explores the implications of using human rights principles as a basis to challenging a resource allocation decision by a primary care trust in the courts. It explores the implications of the recent decision in R (Condliff) v North Staffordshire NHS Trust [2011] and the prospects for development of future litigation.

Privacy, confidentiality and abortion statistics: a question of public interest?

The precise nature and scope of healthcare confidentiality has long been the subject of debate. While the obligation of confidentiality is integral to professional ethical codes and is also safeguarded under English law through the equitable remedy of breach of confidence, underpinned by the right to privacy enshrined in Article 8 of the Human Rights Act 1998, it has never been regarded as absolute. But when can and should personal information be made available for statistical and research purposes and what if the information in question is highly sensitive information, such as that relating to the termination of pregnancy after 24 weeks? This article explores the case of In the Matter of an Appeal to the Information Tribunal under section 57 of the Freedom of Information Act 2000, concerning the decision of the Department of Health to withhold some statistical data from the publication of its annual abortion statistics.