Law & Ethics in Intensive Care

Covers recent changes to the law including the passing of the Human Tissue Act in 2004; the Mental Capacity Act in 2005; the Bristol Inquiry; and the Alder Hey Inquiry.Features clinical scenarios which illustrate real problems, with discussion of the legal and ethical framework that arises from these scenarios, and possible solutionsEmphasizes practical information which will inform all professionals involved with patients admitted to the ICU Critical care is a highly complex area of medicine, in which 30% of patients are expected to die. Developments in law have had a major impact on treatment expected and received in the ICU. However, the law and ethics surrounding clinical practice are not always clear, and generate much concern for those working in intensive care. This book outlines how the law has changed and the impact this has had on the practice of intensive care medicine. Particular clinical scenarios are outlined to illustrate real problems that develop during normal clinical practice, with discussion of the legal and ethical framework that arises from these scenarios, and possible solutions to the problems that are identifed. It also covers issues such as consent, who decideschildren's rights, living wills, withholding and withdrawing of life-saving care, whether there is a right to insist on treatment, definitions of 'death', ICU funding, and the breaking of bad news. The emphasis is on practical information that will inform all professionals involved with patients admitted to the ICU, including doctors, nurses and allied health professionals.Readership: All doctors, nurses, and allied health professionals working in the Intensive Care Unit. It will also appeal to legal professionals working in medical law. Edited by Chris Danbury, Consultant in Anaesthesia and Pain Medicine, Royal Berkshire Hospital, Reading, Chris Newdick, Professor of Health Law at the University of Reading, Carl Waldmann, Consultant in Anaesthesia and Pain Medicine, Royal Berkshire Hospital, Reading, and Andrew Lawson, Consultant in Anaesthesia and Pain Medicine, Royal Berkshire Hospital, ReadingContributors: Dr Dominic Bell, Consultant in Anaesthesia, Leeds General Infirmary, Leeds, UKProfessor Hazel Biggs, Professor of Medical Law, School of Law, University of Southampton, UKDr MargaretBranthwaiteDr Daniele Bryden, Royal Hallamshire Hospital, Sheffield, UKDr John Coggan, University of Manchester, UKDr Chris Danbury, Consultant in Intensive Care Medicine and Anaesthetics, Royal Berkshire Hospital, Reading, UKDr Andrew Lawson, Consultant in Anaesthesia and Pain Medicine, Royal Berkshire Hospital, Reading, UKProfessor S. A. M. McLean, University of Glasgow, UKDr Derek MorganProfessor Chris Newdick, School of Law, The University of Reading, UKMr N PeacockMr D Pittaway QC, Hailsham ChambersDr Neil Soni, Consultant in Intensive Care and Anaesthetics, Chelsea and Westminster Hospital, London, UKDr Carl Waldmann, Consultant Intensive Care andAnaesthesia, Royal Berkshire Hospital, Reading, UKDr T Woodcock, Southampton General Hospital, UK Dr A. Lawson: An introduction to ethical modelsDr M. Branthwaite: Evolution of healthcare lawSection A: Issues of competence and autonomy1: Dr M. D. Bell: Consent for intensive care - public and political expectations vs. conceptual and practical hurdles2: Dr D. Bryden: Adults who lack capacity to consent3: Professor C. Newdick & Dr C. M Danbury: The best interest of babies and childrenSection B: A. Issues between doctor and patient4: Professor S. A. M. McLean & Dr D. Morgan: Taking it or leaving It: demanding and refusing treatment in intensive care5: Professor H. Biggs: Dying to know: legal and ethical issues surrounding death and Do Not Resuscitate orders6: Dr A. Lawson: Diagnosing death7: Dr T. Woodcock: Research in intensive careSection C: A. Managing the Intensive Care Unit8: Mr D. Pittaway QC & Mr N. Peacock: NHS governance of critical care9: Professor C. Newdick & Dr C. M. Danbury: Reverse triage? Managing scarce resources in intensive care10: Dr J. Coggon: Doing what's best: organ donation and intensive care11: Dr C. Waldmann, Dr N. Soni & Dr A. Lawson: Conflicts of interest