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As it is in medicine, so it is in law: the rules for when one can give legally valid consent to medical treatment differ for minors and adults. This paper analyses Singapore's first judgment concerning medical decision-making by and on behalf of mature minors: a Family Court decision on Gillick competence in the context of COVID-19 vaccination. This paper also discusses its implications for medical practice and critiques the age of majority in Singapore. [ABSTRACT FROM AUTHOR]

After #MeToo, academics have become increasingly focused on the liberal concept of consent. Either problematized as a means of distinguishing between sex and rape, or vaunted as a tool for having better sex, consent remains central to discussions of sexual violence. Returning to Andrea Dworkin's thought, this article argues that contemporary feminists must move beyond consent and recenter the problem of violence to theorize rape. Dworkin, alongside Catharine MacKinnon and Carole Pateman, critiques consent for disguising the violence of rape, sex, and pornography. By defining violence as a process of objectification, Dworkin exposes rape, pornography, and most controversially, consensual heterosexual intercourse as "a new kind of death." She, in turn, calls for the feminist exercise of violence as a tactic of disclosure that promises to make visible patriarchal violence hidden by consent and sexualization. Moving beyond consent to recenter the problem of violence, I conclude, opens up new avenues for feminist action and brings into view the seemingly unthinkable possibility of a world without rape. [ABSTRACT FROM AUTHOR]

Issues pertaining to research misconduct and/or breach of research norms and standards have recently come to occupy a central place in research activities. In this article, we argue that a moral character-based approach (Aristotelian virtue ethics) and a self-regulating approach (Kantian deontology) can play a vital role if incorporated in health research ethics training workshops for research ethics committees (RECs) and researchers. We are of the view that on top of what institutions can develop as their best ethics guidelines, policies and regulatory framework, they should also prioritise capacitating their RECs and researchers on virtue ethics to make them appreciate the primacy of virtuous character when reviewing protocols and during the conduct of research. We, therefore, suggest that capacity building through research ethics training should incorporate the moral theories focusing on self-regulating and acquisition of moral character because these moral theories provide the underpinnings of the moral basis in respect of humanity and dignity, integrity, attainment of virtues and development of moral character. [ABSTRACT FROM AUTHOR]

Recital 33 GDPR has often been interpreted as referring to 'broad consent'. This version of informed consent was intended to allow data subjects to provide their consent for certain areas of research, or parts of research projects, conditional to the research being in line with 'recognised ethical standards'. In this article, we argue that broad consent is applicable in the emerging field of Computational Social Science (CSS), which lies at the intersection of data science and social science. However, the lack of recognised ethical standards specific to CSS poses a practical barrier to the use of broad consent in this field and other fields that lack recognised ethical standards. Upon examining existing research ethics standards in social science and data science, we argue that they are insufficient for CSS. We further contend that the fragmentation of European Union (EU) law and research ethics sources makes it challenging to establish universally recognised ethical standards for scientific research. As a result, CSS researchers and other researchers in emerging fields that lack recognised ethical standards are left without sufficient guidance on the use of broad consent as provided for in the GDPR. We conclude that responsible EU bodies should provide additional guidance to facilitate the use of broad consent in CSS research. [ABSTRACT FROM AUTHOR]

Decision-making capacity (DMC) among psychiatric inpatients is a pivotal clinical concern. A review by Okai et al. (2007) suggested that most psychiatric inpatients have DMC for treatment, and its assessment is reliable. Nevertheless, the high heterogeneity and mixed results from other studies mean there is considerable uncertainty around this topic. This study aimed to update Okai's research by conducting a systematic review with meta-analysis to address heterogeneity. We performed a systematic search across four databases, yielding 5351 results. We extracted data from 20 eligible studies on adult psychiatric inpatients, covering DMC assessments from 2006 to May 2022. A meta-analysis was conducted on 11 papers, and a quality assessment was performed. The study protocol was registered on PROSPERO (ID: CRD42022330074). The proportion of patients with DMC for treatment varied widely based on treatment setting, the specific decision and assessment methods. Reliable capacity assessment was feasible. The Mini-Mental State Examination (MMSE), Global Assessment of Function (GAF), and Brief Psychiatric Rating Scale (BPRS) predicted clinical judgments of capacity. Schizophrenia and bipolar mania were linked to the highest incapacity rates, while depression and anxiety symptoms were associated with better capacity and insight. Unemployment was the only sociodemographic factor correlated with incapacity. Assessing mental capacity is replicable, with most psychiatric inpatients able to make treatment decisions. However, this capacity varies with admission stage, formal status (involuntary or voluntary), and information provided. The severity of psychopathology is linked to mental capacity, though detailed psychopathological data are limited. [ABSTRACT FROM AUTHOR]

This article explores the concept of consent in rape law and proposes a new approach based on human dignity. It argues that consent is a contested concept and that grounding rape law solely in sexual nonconsent is problematic. The article suggests that a focus on human dignity, as a moral imperative of respect for persons, could provide a more comprehensive and morally grounded framework for rape law. It discusses the limitations of consent-based approaches, examines the gendered dimensions of consent, and explores alternative frameworks for understanding and addressing sexual violence. The article concludes by advocating for a model rape statute grounded in human dignity. [Extracted from the article]

The field of fertility preservation (FP) for oncology patients has evolved significantly in recent years, offering new possibilities for individuals with life-threatening illnesses. We commend Jones et al. for their comprehensive ethical review of offering FP to patients with poor prognoses, acknowledging the potential benefits that it may bring. ‘Poor prognosis’ in this context implies a high likelihood of death due to cancer progression. We highlight the importance of considering posthumous reproduction, involving the use of cryopreserved gametes or embryos to conceive a child after one or both partners have passed away, a topic briefly mentioned by Jones et al. Posthumous reproduction raises complex ethical, logistical, and legal questions. Distinctions between cryopreserved sperm and oocytes are discussed, with each scenario presenting unique challenges. The article also examines the complexities faced by same-sex couples in posthumous reproduction, addressing issues related to donor selection, legal parentage, and rights. Legal and regulatory aspects play a crucial role, including obtaining clear and legally valid consent, defining parental rights, navigating surrogacy laws, and addressing inheritance and estate planning. Ethical dilemmas require healthcare professionals to ensure informed decision-making, consider psychological impacts, and offer information on alternative family-building options.

In the EU Member States whose legal systems recognise the relationship between a patient and a healthcare provider as a private law relationship, the approach to its regulation is not homogeneous. In principle, two regulatory models can be distinguished. The first model consists of a reconstruction of this relationship's content based on all the legal provisions available in a given legal system. The second model regulates the relationship in question in the civil code, as a type of a named contract. Although Poland represents the first regulatory model, it has already taken steps to shift to the latter one, despite the increasingly dwindling enthusiasm to do so. This article presents the development of the conceptual work in Poland regarding this area, the existing regulatory dilemma, as well as conclusions arising from the comparative legal analysis. [ABSTRACT FROM AUTHOR]

Non-invasive prenatal testing (NIPT) can be used to determine the chromosomal sex of the fetus at an early stage in a pregnancy. The use of NIPT for fetal sex determination raises concerns about potential selective termination of pregnancy by prospective parents who desire a child of a particular sex. Although sex selection for medical reasons is generally accepted, non-medical sex selection (NMSS) has been the subject of considerable controversy. In this article, we explore the current regulatory landscape around reproductive genetic testing techniques that may lead to NMSS, both internationally and within Australia. Specifically, we contrast the approach to regulating preimplantation genetic testing (PGT) with the minimal regulation of NIPT in Australia as a case study for reform. We examine ethical concerns raised in relation to NMSS, which form the basis of the current moratorium on the use of PGT for NMSS. We then highlight some key differences between using PGT for NMSS and NIPT for fetal sex determination to determine whether access to the latter should be regulated and, if so, how. We conclude that there is insufficient evidence to restrict access to NIPT for fetal sex determination and, based on our Australian case study, recommend a facilitative approach to regulating NIPT that would support individuals to make informed reproductive decisions. [ABSTRACT FROM AUTHOR]

Autistic adults have similar levels of desire for sexual and romantic relationships as their non-autistic peers. However, autistic adults are less likely to be in relationships and have less dating experience. We compared sexual knowledge, experiences, and pragmatic language ability in a community sample of young adults with (n = 27, mean age = 22.11) and without autism (n = 122, mean age = 19.47). Receipt of sex education and sexual knowledge did not differ between groups. However, autistic adults had significantly fewer partnered experiences and impaired pragmatic language. Within both groups, pragmatic skill predicted accurate sexual knowledge above and beyond general communication abilities. Findings suggest that sex education for autistic adults must address the social communication component of healthy romantic and sexual relationships. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to evaluate the processes of informed consent and identify factors affecting the comprehension and decision-making of the patient who undergoes hyperbaric oxygen treatment (HBOT). Methods: This cross-sectional study group consisted of patients admitted to the Department of Underwater and Hyperbaric Medicine. Patients were verbally informed about the process and allowed to read the informed consent form before they received HBOT. Having provided the information of consent, the participants completed a questionnaire including the descriptive features, an informed consent checklist form, a Standardized Mini Mental Test (SMMT), and screening tests for decisional conflict. The results were evaluated. Results: Fifty-six patients participated in the study. The mean age was 46.4±13.5 years and 75% of patients were men. Among the participants, 5.4% tended to feel uncomfortable with the decision they made, and 7.1% experienced decisional conflict. When the patients were asked "Who is the best person to decide about the treatment recommended for you?", 53.6% of patients responded as "The doctor." When the scales and form points used in the study were compared in terms of gender and educational level, statistically significant differences were observed between the points for SMMT (0.048) according to gender and the points for SMMT (0.001) as well as the screening test for decisional conflict (0.027) according to educational status. Conclusion: The current research is the first study in the literature to show the crucial role of informed consent and the factors affecting comprehension as well as the decision of the patient undergoing HBOT. As a result, Underwater and Hyperbaric Medicine physicians must consider various aspects of the consent process to reduce the risk of malpractice and ensure good clinical practice. [ABSTRACT FROM AUTHOR]

The present survey evaluated the level of awareness of radiological protection concepts and imaging parameters among Sri Lankan radiographers for the first time. The data were collected using an electronic questionnaire of 22 questions on demographic data, awareness of radiation protection concepts and imaging parameters. Only 84 out of 122 (68.8%) requested radiographers to return the questionnaire. More than 85% had ≥3 years of experience in the radiography field. The average scores for questions on best practices, imaging parameters and radiation protection were 75, 75.8 and 70.2%, respectively, with an overall score of 73.4%. Significant confusion existed on protective shielding, paediatric consenting capability, use of grids and excess X-ray field during paediatric radiography. Although the overall knowledge and awareness of participants on studied concepts were satisfactory, a continuous professional development credit system and implementation of a code of practice are required to improve the quality of radiography practice. [ABSTRACT FROM AUTHOR]

This article outlines and critiques the Australian jurisprudence that has addressed whether minors are able to lawfully consent to gender-affirming hormone treatment, with reference to the landmark decision of Gillick v West Norfolk and Wisbech Area Health Authority. Although the principle of Gillick competency is well recognised in law, the Australian legal developments that apply Gillick to decisions about the commencement of gender-affirming treatment, have taken the principle astray. The approach under Australian law has diverged down a path that does not align with the original reasoning in Gillick, nor its contemporary interpretation. I outline the reasoning in Gillick so that the foundational principles are considered before discussing how Gillick has been interpreted and applied in subsequent cases. I then provide an outline of the key legal developments in Australia relevant to minors and the commencement of hormone treatment for gender dysphoria. I undertake a critique of the Australian law in this field and conclude that there is a need for future judicial determination of how Gillick should be applied, not only in the cases relevant to gender dysphoria, but beyond, so that the position in respect of minors' decision-making is clarified. This is vitally important because the current approach to this issue has potential implications beyond cases relevant to gender-affirming hormone treatment. [ABSTRACT FROM AUTHOR]

How can caregivers' interests be balanced with disability rights in decisions about whether to sterilise an intellectually disabled person? This question is considered in the context of Singapore, a commonwealth country that lacks a test case. Singapore has a lesser-known history of eugenics, and has struck an uneasy compromise between communitarian values and obligations under the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in recent years. This article provides an overview of Singaporean law under the Voluntary Sterilisation Act 1974 and the Mental Capacity Act 2008, and compares this with the law in Canada, England and Wales, and Australia. This article also situates the CRPD in the context of Singapore's dualist view of international law and communitarian approach to disability policy. It argues that CRPD rights to bodily integrity can be presumptively upheld in best interests determinations on sterilisation, while caregivers' interests can be accommodated in a relational understanding of best interests. A decisional framework along these lines is proposed. [ABSTRACT FROM AUTHOR]

The use of video conferencing applications has increased tremendously in recent years, particularly due to the COVID-19 pandemic and the associated restrictions on movements. As a result, the corresponding smart apps have also seen increased usage, leading to a surge in downloads of video conferencing apps. However, this trend has generated several data protection and privacy challenges inherent in the smart mobile ecosystem. This paper aims to study data protection issues in video conferencing apps by statistically and dynamically analyzing the most common such issues in real-time operation on Android platforms. The goal is to determine what these applications do in real time and verify whether they provide users with sufficient information regarding the underlying personal data processes. Our results illustrate that there is still room for improvement in several aspects, mainly because the relevant privacy policies do not always provide users with sufficient information about the underlying personal data processes (especially with respect to data leaks to third parties), which, in turn, raises concerns about compliance with data protection by design and default principles. Specifically, users are often not informed about which personal data are being processed, for what purposes, and whether these processes are necessary (and, if yes, why) or based on their consent. Furthermore, the permissions required by the apps during runtime are not always justified. [ABSTRACT FROM AUTHOR]

Many "anti-something" medications, which are prescribed by medical doctors for older patients, often for dubious reasons, result in a serious reduction in the quantity and quality of saliva. That drug-induced xerostomia can produce dangerous dental decay, particularly in already compromised dentitions. This article suggests that doctors should undertake a personalised "benefits, risks, alternatives, nothing" (BRAN) analysis including an assessment of the possible dental decay risks, especially before prescribing combinations of "anti-" drugs for marginal conditions. Doctors should consider carefully if alternative approaches are feasible which could produce acceptable outcomes without incurring those serious dental decay risks. Alternative approaches may include patients altering their diet and lifestyle to include more physical exercise for controlling conditions such as marginal hypertension, for example, or perhaps prescribing counselling/talking therapies for depression or anxiety. If various "anti-" drugs really do have to be prescribed, this article describes cheap, pragmatic, and effective ways of mitigating the risks of already compromised dentitions developing new decay. [ABSTRACT FROM AUTHOR]

Introduction A well-established principle is that informed consent is an obligatory requirement for any medical intervention; a patient’s decision-making capacity to consent is a requirement for legally valid consent. Some individuals may be unable to give valid informed consent due to their limited mental capacity. In such cases, laws permit substitute decision-making and involvement of the patient as far as possible (Art.6, Oviedo Convention). National laws of European countries allow persons with mental health problems to be deprived of their liberty and undergo involuntary treatment, namely treatment without a patient’s informed consent, in certain circumstances. Procedural safeguards must be secured, and a court must review its lawfulness (FRA, 2012). The legality of involuntary treatment is highly debated by various audiences (CRPD committee, CoE bodies). In Latvia and other countries, the requirement to assess a person’s decision-making capacity in the application of involuntary treatment is not required. Objectives This study was conducted to reveal the role of a person’s decision-making capacity to consent to the treatment of mental disorders in cases where involuntary treatment was approved by courts. Methods A retrospective case law study method was applied. Anonymised decisions of Latvian courts at www.manas.tiesas.lv in cases of involuntary treatment in Latvian adult psychiatric hospitals since 2010 were collected and analysed. The content of decisions concerning persons’ decision-making capacity and applicable legal regulations were studied. Results The case law revealed that the decision-making capacity had not been addressed regularly and in detail. Latvian law does not require an assessment of capacity, and as a result, the courts do also not require any data. Some elements of decision-making abilities, such as the limited ability to comprehend or process information, are mentioned in the decisions of courts. Conclusions There is a need to address the significance of decision-making capacity in the application of patients’ rights law in clinical and legal settings when involuntary treatment is suggested or applied. There is a need to amend the laws justifying the limitations of patients’ rights, particularly concerning involuntary treatment. Acknowledgements This paper has been prepared within the research project “Towards a human rights approach for mental health patients with a limited capacity: A legal, ethical and clinical perspective”, No. lzp-2020/1-0397 and the project “Strengthening of the capacity of doctoral studies at the University of Latvia within the framework of the new doctoral model, identification No.8.2.2.0/20/I/006” Disclosure of Interest None Declared

In September 2021, the Court of Appeal reversed the controversial decision of Quincy Bell v Tavistock and Portman NHS Trust in a victory for transgender rights. At first instance, the Divisional Court had set a high legal threshold for transgender children to attain Gillick competence to consent to treatment with puberty blockers – effectively restricting access to treatment for many. On appeal, the Court of Appeal held that children are capable in law of giving valid consent to treatment for gender dysphoria, and court authorisation would not be routinely required before children could access such treatment. This note considers the implications of the Court of Appeal decision for the law on minors and consent to medical treatment in the transgender health context. [ABSTRACT FROM AUTHOR]

This article outlines the Australian legal position relevant to minors and the commencement of hormone treatment for Gender Dysphoria (GD). It traces the significant Australian legal developments in this field and compares the Australian jurisprudence with recent English caselaw. In Quincy Bell and Mrs A v The Tavistock and Portman NHS Foundation Trust and Ors , the English High Court held that minors below 16 years are not likely to have the requisite competency to lawfully consent to the commencement of puberty suppressing drugs. The Court of Appeal subsequently overturned this decision, but there are important aspects of the High Court's reasoning that warrant further analysis, particularly some of the underlying reasoning about the nature of GD as a condition and its treatment. This article highlights several common themes when comparing the High Court's reasoning in Bell with Australian jurisprudence and highlights how the Australian position has advanced significantly since the first Australian cases in this field were decided. This comparison shows that the Australian perspective is important in demonstrating how judicial views can advance over time alongside a deeper understanding of GD, its treatment, and the broader impact of a requirement to involve the court in such cases. It is concluded that the Australian perspective should be considered in future English cases. [ABSTRACT FROM AUTHOR]

Introduction: hemodynamic changes during tracheal intubation it is more challenging in head injury patients. Dexmedetomidine is a selective a2 adrenoreceptor agonist used as a sedative and adjuvant with local anesthetic. We hypothesized that adding dexmedetomidine to ropivacaine before intubation have positive outcome on hemodynamic changes. Aim and objective: To assess the effect of Intratracheal Dexmedetomidine with ropivacaine on hemodynamic changes during intubation in head injury patient .Methodology: Sixty patients admitted in ICU with head injury and need intubation randomly divided into two groups 30 subjects in each group, namely, Group 1 and Group 2. Group 1 received dexmedetomidine 0.5 ml with 0.5% ropivacaine 0.5 ml whereas Group 2 receive normal saline before endotracheal intubation, respectively. The outcomes were the incidence hemodynamic fluctuations during intubation and after intubation .Results: The incidence and severity of hemodynamic fluctuation in Group 1 than in the group 2, during intubation and post intubation is significantly lower. Moreover, compared with Group 2, Group 1 exhibited more stable haemodynamics during intubation as well as post intubation .Conclusion: The combined use of dexmedetomidine and ropivacaine intratracheally before intubation significantly reduced the incidence and severity of haemodynamic fluctuations during and after intubation. [ABSTRACT FROM AUTHOR]

Copyright of Inonu University Law Review / İnönü Üniversitesi Hukuk Fakültesi Dergisi is the property of Inonu University Law Review (IULR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The legal will agreement producing legal effects means that each party will is real, conscious, free and clear, externalized and expressed the intention to be bound. Through legal concepts of will and consent, a purely psychological approach objectifies producing legal effects. The whole argument is based on the idea that an interdisciplinary approach of the law requires updating the content of the concepts reflecting processes and mental phenomena which can be scientifically investigated with the methods and techniques of modern science. Analysis of classical theories of the will and the modern theories on the decision making process revealed the evolution of decision making research and the importance of including these valuable scientific information within the factors influencing civil act theory as a manifestation of the will and the concept of contractual freedom. [ABSTRACT FROM AUTHOR]

With aims to both increase organ supply and better reflect individual donation preferences, many nations worldwide have shifted from 'opt‐in' to 'opt‐out' systems for post‐mortem organ donation (PMOD). In such countries, while a prospective donor's willingness to donate their organs/tissues for PMOD was previously ascertained—at least partially—by their having recorded positive donation preferences on an official register prior to death, this willingness is now presumed or inferred—at least partially—from their not having recorded an objection to PMOD—on an official organ donation register. Using evidence regarding the presence and prevalence of selective donation preferences, and via exploration of how appeals to donation preferences are used to both motivate and legitimate shifts to opt‐out frameworks, this paper draws attention to a set of previously unexplored problems for opt‐out organ donation arising in contexts where: (a) individuals demonstrate selective post‐mortem organ/tissue donation preferences, (b) legislation provides prospective donors with the opportunity to selectively permit/refuse the donation of certain organs/tissues in line with these preferences. While selective preferences pose few problems for opt‐in systems where a selective occasion is built into the process of signing the donor register, this is not the case for opt‐out systems. The loss of this selective occasion can cause significant problems where appeals to preferences motivate/legitimate shifts to opt‐out but evidence regarding variable preferences does not feed into determinations regarding organ/tissue exclusions. The nature of these problems depends on how the authorization aspect of 'opt‐out' systems is framed (e.g. as presumed consent, deemed consent or, given the role of familial consent in many jurisdictions as consent in name only). [ABSTRACT FROM AUTHOR]

The right to informed consent (IC), as established in the Supreme Court judgment in Montgomery v Lanarkshire Health Board [2015] UKSC 11, I claim involves a 'journey of love' between clinicians and patients. The latter entails a process of dialogue and support between the parties, concerning disclosure of risks, benefits and alternatives to medical treatment(s). In this paper, I first claim that IC, in the light of the spirit of Montgomery, is predicated upon two pillars, namely patients' autonomy and medical partnership. I will then explore a case study: the case of legal abortion in England and Wales. Regarding this case, the progressive reduction of medical involvement has meant that little opportunity has been provided for this 'journey' to be unpacked in a medical context. I will ultimately claim that more needs to be done to safeguard IC as a 'journey of love' through valuing both patients' autonomy and medical partnership. [ABSTRACT FROM AUTHOR]

Whereas much research with adolescents in Africa engages them mainly with respect to issues limited and explicitly related to youth, this research note makes epistemic and methodological arguments for engaging adolescents more broadly in our research about Africa. I present a practical application of research design and methods based on these arguments through a study with adolescents in a secondary school in Ghana in which I engendered their enthusiastic participation in the research process. Through this, I demonstrate how taking a critical approach to epistemologies and methodologies in research with young participants can expand and enrich our knowledge of and about the continent. [ABSTRACT FROM AUTHOR]

Copyright of Acta Bioéthica is the property of Universidad de Chile, Centro Interdisciplinario de Estudios en Bioetica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The terms "paedophilia" and "paedophile" appear regularly in any discourse on sexual offences against children. However, whether their use is justifiable is debatable, as is the question of whether framing this category of offence, and the defining characteristics of those who commit it (and in particular their state of mental health), in these terms justifies claiming that paedophilia is the underlying issue. This article examines the terminological differences between the definition of paedophilia used in medical diagnosis and the very specific definition enacted in the Polish Criminal Code (Art. 200, Para. 1). The results of empirical studies are presented below. Case files under this provision are examined, with special emphasis on the typology of offences and data on the mental health of offenders. This research was conducted as part of Research Project No. 2013/09/N/HS5/04247 and was financed by the National Science Centre. These studies show that a significant proportion of offences labelled "paedophilic" are nothing more than consensual sexual acts between adolescents and that the proportion of offenders afflicted with sexual preference disorders is negligible. The vast majority of cases do not involve paedophilia in the medical sense of the term, and using it this way gives a distorted picture of the topic and steers most of the discussion of it on a completely misguided path. [ABSTRACT FROM AUTHOR]

Background: The law and literature about children's consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to "want" to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain the differences between theories and practices about the ages when children begin to be informed about elective heart surgery, and when their consent or refusal begins to be respected? Research design, participants and context: Research methods included reviews of related healthcare, law and ethics literature; observations and conversations with staff and families in two London hospitals; audio-recorded semi-structured interviews with a purposive sample of 45 healthcare professionals and related experts; interviews and a survey with parents and children aged 6- to 15-years having elective surgery (not reported in this paper); meetings with an interdisciplinary advisory group; thematic analysis of qualitative data and co-authorship of papers with participants. Ethical considerations: Approval was granted by four research ethics committees/authorities. All interviewees gave their informed written consent. Findings: Interviewees explained their views and experiences about children's ages of competence to understand and consent or refuse, analysed by their differing emphases on informed, signified or voluntary consent. Discussion: Differing views about children's competence to understand and consent are associated with emphases on consent as an intellectual, practical and/or emotional process. Conclusion : Greater respect for children's practical signified, emotional voluntary and intellectual informed consent can increase respectful understanding of children's consent. Nurses play a vital part in children's practitioner-patient relationships and physical care and therefore in all three elements of consent. [ABSTRACT FROM AUTHOR]

This article uses Ernst Fraenkel's concept of the "dual state" as the vehicle for examining the role of "lynch law" as a mode of governance of African Americans in the United States from 1865 to 1940 (roughly). It begins with a largely jurisprudential inquiry placing my interpretation of Ernst Fraenkel's distinction between the normative state and the prerogative state in dialogue with a version of American Legal Realism, in which law consists entirely of "moves" such as permissible distinctions and analogies that are treated (sociologically) as acceptable by relevant professional communities. Seen through that lens the distinction between the normative state and the prerogative state thins out. The arbitrariness Fraenkel associates with the prerogative state infects the normative state and the prerogative state is pervaded by norms that aren't mere simulacra of legal norms. The two kinds of state are different in degree rather than in kind—but differences in degree can matter. Part II uses the revised distinction in a preliminary examination of lynch law in the U.S. South. Lynch law was not an example of Fraenkel's prerogative state; the norms enforced through lynch law might have been popular versions of norms drawn from the prerogative state. And yet "lynch law" was different not only in content from the rules of law formally applicable to all people in the United States but also in the lived experience of those subject to lynch law. Lynch law might not have been arbitrary in the sense that it had no knowable normative content, but, perhaps because the norms were popular rather than legislated or formal, it was substantially vaguer than the formal law and significantly less able to guide the choices made by those subject to it. [ABSTRACT FROM AUTHOR]

Background: Informed consent is an integral part of the process prior to any surgical procedure [1]. Flexible cystoscopy is a common day case urological procedure and it is the gold standard investigation for visible haematuria [2]. Aim: To assess if postal consent is a suitable form of gaining informed consent for flexible cystoscopy. Methods: Patients booked for a flexible cystoscopy are initially reviewed in clinic. An information leaflet with an attached consent form is then posted to their home 2 weeks prior to their procedure. We designed a short questionnaire, to assess patient's satisfaction and understanding of the literature, given to them after the procedure. Results: Sixty-seven questionnaires were completed. The mean age was 54. Sixty patients (93%) think that postal consent is of benefit to the patient. Sixty-one patients (91%) read the information sheet and felt that there was enough information regarding the procedure on it. Fifty-four patients (81%) had no difficulty understanding the consent form. Forty patients (60%) signed the form prior to arrival in the hospital. Conclusion: Postal consent is commonly used for gastro-intestinal endoscopy procedures. Postal consent for flexible cystoscopy is not well reported in the literature. Our study shows postal consent to be a suitable form of gaining informed consent for flexible cystoscopy. [ABSTRACT FROM AUTHOR]

Uterus transplantation (UTx) is fast evolving from an experimental to a clinical procedure, combining solid organ transplantation with assisted reproductive technology. The commencement of the first human uterus transplant trial in the United Kingdom leads us to examine and reflect upon the legal and regulatory aspects closely intertwined with UTx from the process of donation to potential implications for fertility treatment and the birth of the resultant child. As the world's first ephemeral transplant, the possibility of organ restitution requires consideration and is discussed herein. Uterine transplantation warrants a closer look at the legal frameworks on fertility treatment and transplantation in England. Uterine transplantation warrants a closer look at the legal frameworks on fertility treatment and transplantation in England. [ABSTRACT FROM AUTHOR]

The experimental philosophy of law is a recent movement that aims to inform traditional debates in jurisprudence by conducting empirical research. This paper introduces and provides a systematic overview of the main lines of research in this field. It also covers the most important debates in the literature regarding the implications of these findings for the philosophy and theory of law. It argues that three challenges arise when addressing (old) legal‐philosophical questions in (new) experimental ways by drawing normative implications from empirical data: such implications are value‐driven, depend on explanations of empirical findings and vary across legal systems. [ABSTRACT FROM AUTHOR]

No known cure exists for COVID-19, and medical practitioners are exhausted and at their wits' end trying to find treatments that prevent patients from ending up in hospital or intensive care, or even dying. A variety of treatments tried by medical practitioners include standard registered medicine, investigational or so-called experimental, unapproved or preapproved medicines, emergency or compassionate-use authorised medicine and pre-market approved medicine. However, the medicines that can be accessed via each of these categories are at different stages of efficacy testing and knowledge about adverse effects, dosages and risks. To obtain ethical and legal informed consent, medical practitioners must deal with a lot of medical uncertainty, and care must be taken to ensure that the patient understands the difference in risks they may be willing to take depending on the medicine's stage of development. Often additional information is required to obtain ethical consent as opposed to legal consent. A purely legal approach to informed consent, especially when dealing with the medical uncertainties of health emergencies and pandemics, may lead to patients' consent lacking in enough substance to be truly considered legal and ethical. Informed consent as respect for autonomy in this sense requires more than the patient's explicit agreement or compliance with a certain treatment proposal. This article explains the difference in consent content attached to each different stage of a medicine's development, especially considering the additional difficulties posed by obtaining truly informed consent during a pandemic with uncertain characteristics, treatment and solutions. [ABSTRACT FROM AUTHOR]

Contents I Introduction II NIPT and Current Relevant Guidelines A Current NIPT Technology and the Regulatory Landscape B General Guidelines on Prenatal Testing C Specific Guidelines on Prenatal Testing for [...], Non-invasive prenatal testing ('NIPT') enables quick, safe and generally reliable screening during early pregnancy. NIPT is currently available in Australia for screening for conditions such as trisomy 21 ('Down Syndrome') which are immediately apparent at birth. NIPT may also be used in the future to detect adult-onset disorders and risk profiles for conditions which manifest later in life. Although expanded prenatal testing has the potential to enhance reproductive choice, the use of NIPT to detect adult-onset conditions raises significant ethical concerns about the welfare of the future child. In this article, we explore the legal and ethical issues raised by NIPT for adult-onset conditions. We make some preliminary proposals for regulating access to NIPT, which encourage prospective parents to consider the interests of the future child through careful genetic counselling.