Medical Law: Text, Cases, and Materials

Product Information

The law and DIY Assisted Conception’ in Kirsty Horsey (ed) R egulating Assisted Conception (Routledge, 2015), 31-49 IVF birth data presentation: Its impact on clinical practice and patient choice’ in Martin Johnson et al (eds) Birth Rites and Rights (Hart, 2010) It is not irrational, or irrelevant to seek assurances that the decision will be made in a reasonable way, and the disclosure of information can provide this kind of assurance. That is, a patient can want to be assured that a good decision will be made (by someone else) without wanting to make that decision herself. 107

Extracts from a wide variety of academic materials ensure students acquire an overview of a range of different perspectives Medical Law : Text, Cases, and Materialsoffers all of the explanation, commentary, and extracts from cases and key materials that students need to gain a thorough understanding of this complex topic. Yeah, Umar has already cut out the pictures and cropped them. [Laughs] So yes we will tell the child who they are. Like I said we’ll probably inform the egg donor or just message her on Facebook to say thank you and this is what you’ve done for us. We want to keep in touch somehow if you’re happy to. But I guess that’s her call. But yeah, we’re more than happy to do that. A woman who learns … that her lifetime risk of breast cancer is ‘12%’ … needs to be made aware that ‘12%’ is not a literal representation of her own ‘true’ risk but a figurative expression of scientists’ confidence based on the aggregated outcomes of individuals whose characteristics are similar—but not completely equivalent—to her own. 77 Assisted Conception and Surrogacy in the United Kingdom’ in ‘Assisted Conception and Surrogacy in the United Kingdom’ in J Eekelaar and R George (eds) Routledge Handbook of Family Law and Policy (Routledge, 2020) 187-199

Look, I was following what people were saying about contracts and to get the contract looked at … I think some of the advice that people have shared was it costs a lot of money to have your contracts looked at and it’s not actually legal or legally viable in Australia anyway. There’s no real — … So I didn’t actually — then I decided not to seek legal advice because I just thought it was almost pointless. A response to Saviour Siblings: A Relational Approach to the Welfare of the Child in Selective Reproduction' (2015) 41 Journal of Medical Ethics 929-30 Then [my partner] Wayne mentioned the word—the phrase ‘commercial surrogacy’. At that point Dr C said ‘no’. He just doesn’t want to know anything about it. He said don’t talk to me about that. It’s illegal, it’s—basically, the door was shut at that point here in Australia. Kai Möller 'Male and Female Genital Cutting: Between the Best Interest of the Child and Genital Mutilation' Oxford Journal of Legal Studies[online first]

In addition to variation in patients’ appetite for and use of information, there is also variation in how much value they attach to information disclosures. Arvind and McMahon have pointed to evidence that what some patients value most in their pre-treatment encounters with doctors is not necessarily information about risks and alternatives 100; instead, patients might be more concerned about whether their health concerns are being taken seriously, and whether they are treated with compassion and respect. 101 Surveys of what matters most to patients often rank being able to trust healthcare professionals above the right to make autonomous decisions. 102 Interpersonal skills are important: patients want their doctors to be sensitive to the embarrassment of being naked in front of fully dressed professionals, to introduce themselves, and not to speak to colleagues over them, as if they are not there. 103 A gap between what matters to experts and what matters to patients is also evident in relation to the law, including but not limited to criminal prohibitions, citizenship and the rules of legal parentage. For example, in our study, it is striking how few intended parents of children born through surrogacy had sought legal formalisation of their relationship. Tom, who had undertaken surrogacy in India said: Although the internet is the primary source of ‘soft’ information about the experience of fertility treatment, it is also worth noting the growing popularity of fertility and surrogacy ‘fairs’ or ‘roadshows’, which are huge exhibitions in which visitors can gather information from regulated clinics and the local regulator, while also meeting people from overseas clinics and ‘alternative’ therapists. Discussions about one’s need for fertility services have emerged from the strict confidentiality of the doctor-patient relationship to become instead a marketing opportunity for private providers. But while these ‘fairs’ provide clinics with the chance to sell their services, potential patients also value the opportunity to find out if they feel a ‘connection’ with the clinic staff and their approach. There is also a mismatch between the view that healthcare professionals have ‘a key role to play in ‘educating’ people about possible risks’, 55 and the fact that healthcare professionals are seldom the first port of call for information. If people seek out information via Google, Facebook, and internet chatrooms, there may be little opportunity for clinicians to educate them about risks and potential pitfalls, a problem which is, as we see in the following section, exacerbated by domestic laws which criminalise CBR, and hence deter patients from incriminating themselves in front of healthcare professionals. V. THE ROLE OF DOMESTIC REPRODUCTIVE SERVICE PROVIDERS

External resources

The fact that a clinician is willing to inform a patient about treatment options may be viewed as indicative of respect (provided it is done so in respectful manner). The clinician treats the patient as someone who is capable of being informed, and who has an interest in being informed. A patient can have an interest in being respected without thereby wanting to make decisions herself. The fact that the clinician is willing to engage in communication may help to inspire confidence in the clinician as a trustworthy agent. 104 One of the Canadian agencies we spoke to assigned a full-time support worker to each surrogate and a different employee to support each set of intended parents. The agent, Sally, explained that these workers played an invaluable role in resolving issues and ensuring that disputes did not arise in the course of the relationship between the parties. In contrast, some of the intended parents who undertook unpaid surrogacy within Australia felt that, after the clinic’s initial counselling session, they were ‘left on their own’. For example, Lachlan describes the limited service provided by the Australian clinic that he and his wife attended: Regulating Non-Invasive Prenatal Testing: the view from the UK' (2014) 50 Japanese Journal of Law and Political Science 9-19. Informed Consent and the Impotence of Tort’ in S. McLean (ed) First Do No Harm(Aldershot, Ashgate, 2006) 273-86