© in This Web Service Cambridge University

Cambridge University Press 978-0-521-74407-2 - Medicolegal Essentials in Healthcare, 2nd Edition Edited by Jason Payne-James, Ian Wall and Peter Dean Index More information

Index

A A-G of British Columbia, Rodriguez v abbreviations, statements of evidence 145 235, 237 AIDS see HIV abortion see termination of pregnancy AIDS (Control) Act (1987) 215 Abortion Act (1967) AIDS Epidemic Update December 2002 amendment by Human Fertilisation (WHO/UNAIDS) 206, 207 and Embryology Act (1990) 150 (Table) offences against 149 Airedale NHS Trust v Bland 130, 131, statutory notification 34 143 Abortion Regulations (1991), statutory AK (Adult Patient), Re (Medical notification 34 Treatment: Consent) 132 abuse of children 159–160 Alder Hey Children’s Hospital, retention acceptable practice 169 of tissues 107–108, 119 Access to Health Records Act (1990) 31, All-Party Parliamentary Group on AIDS 75 215–216 Access to Medical Reports Act (1988) amputation of gangrenous foot, refusal 31, 34 of consent (Re C) 132 actionability per se 115n anal sexual intercourse, AIDS battery 128 transmission 219 active euthanasia 140 anatomical specimens 105 Acts of Parliament 1 Anatomy Act (1832) 105, 119 relevant to medical practitioners, Anatomy Act (1984) 105–106 listed 55 (Table) anonymity actual bodily harm 112 clinical information 37 Adamoko, R v 174 gamete donors 153 Adams, R v 142 anonymous surveillance, unlinked, AIDS administrators, disclosure of clinical 208 information to 37 anorexia nervosa: Re W (A Minor: admission to hospital Refusal of Treatment) 44, early death after 97–98 136n see also detention anticipatory declarations, as refusal of Adoption and Children Act (2000) treatment 42–43 165 anti-viral treatment adults, capacity 40–43 pregnancy, AIDS prevention 208 Adults with Incapacity (Scotland) Act see also highly active anti-retroviral (2000) 143 therapy advance directives see living wills appeals adversarial systems 238 complaints procedures 77 Advisory Council on the Misuse of Drugs from Crown Court 8 226 difference from judicial review 5 Advisory Group on Hepatitis 223 fitness-to-practice decisions 60 Africa, AIDS 206, 208 psychiatric detention 19

© in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-0-521-74407-2 - Medicolegal Essentials in Healthcare, 2nd Edition Edited by Jason Payne-James, Ian Wall and Peter Dean Index More information

242 INDEX

appeals (contd) balance of probability 167, 171 rights, psychiatric detention and Barnett v Chelsea and Kensington treatment 90–92 Hospital Management Committee appraisal, of doctors 63–64 171 Approved Social Workers (ASW) battery 39 Mental Health Act (1983) 84, 86 actionability per se 128 artificial ventilation, cessation 131 Bavaria, HIV legislation 213 assault BBVs see blood-borne viruses on forensic physicians 25–26 Being heard (Wilson Committee) 72 on healthcare professionals, disclosure Bentham, Jeremy 12 of clinical information to police best interests principle 35 children 44, 49n as offence 39 end-of-life decisions 143 see also Offences Against the Person incapacity for consent 40–41 Act (1861) information-sharing by forensic Assessment Referral Committee, GMC physicians 21 60 Bethlem Royal Governors and Others, assisted suicide 144–145, 147n Sidaway v 46, 136–137n living wills and 127 Bills, parliamentary 1 Association of British Pharmaceutical biomedical ethics see ethics Industry, volunteers for clinical biotechnology industry, property in trials, compensation 198 tissues 114 Association of NHS Occupational Nurse Bird, S.M., Leigh-Brown, A.J., on Advisors (ANHONA), on blood- criminality of AIDS-risk behaviour borne viruses 221 219 Association of NHS Occupational birth mothers (surrogate mothers) 113, Physicians (ANHOPs), on blood- 155–156 borne viruses 221 births, statutory notification 34 attendance at court 237–240 Births and Deaths Registration Act attorney, powers of 133 (1953) 96–97, 115n audience, rights of 240 blame-based litigation 174–175 audit Bland, Airedale NHS Trust v 130, 131, of potential organ donors 125 143 use of clinical information 37 bleeding, patients with blood-borne Australia viruses 217 Medical Treatment Act (1988) 134 blood products, blood-borne viruses and Therapeutic Goods Administration 218 195 blood specimens see samples Australia antigen 203 blood transfusion, hepatitis C autonomy 17, 136n screening 218 AIDS and 213–214 transmission 210 see also self-ownership blood-borne viruses (BBVs) 203–231 autopsies see postmortem examinations advice to healthcare professionals, United Kingdom 220–225 B bodies B (Adult: Refusal of Medical Treatment), rights in vivo 112–113 Re 142, 147n see also autonomy; self-ownership B case (In Re O; In Re B), harm to child see also cadaver(s) 164 Bolam test 169, 176n B case (Ms B), living wills 130, 133 necessity for treatment and best B case (R v Gwynedd County Council, ex interests 41 parte B) 115n sufficiency of information for consent B, Lancashire C.C. v 164 to treatment 46, 137n B v A NHS Hospital Trust 131 Bonnington Castings v Wardlaw 172

INDEX 243

Book 83 (custody record) 26 Chelsea and Kensington Hospital Boyes, Lilian (Mrs), rheumatoid arthritis Management Committee, case (R v Cox) 141–142 Barnett v 171 brain stem death 123 chemotherapy (cytotoxic), spinal breach of contract, private practice 170 administration 174 breach of duty 169, 170 Chief Medical Officer, on no-fault Bristol Royal Infirmary, retention of schemes 175 tissues 107–108 child abuse 159–160 British Medical Association, complaints child assessment orders, Children Act and 73 (1989) 164 bruises 237 child destruction, Infant Life burden of proof, civil law vs criminal law (Preservation) Act (1929) 149 74 children Burke (murderer) 114n anti-viral treatment, AIDS prevention ‘but for’ test 171, 172 208 Butler-Sloss, Elizabeth (Dame) 153 consent to treatment 44–45, 49n disclosure of medical records to C parents 32–33 C (Adult: Refusal of Medical Treatment), possession of bodies 115n Re 132, 136n retention of tissues by hospitals 108 C and another v S and another ‘unlicensed use’ of medicines 150–151 190–191 cadaver(s) 105–107 see also minors blood-borne viruses 217 Children Act (1989) 159–166 property rights in 109–111 definition of minors 48n cadaveric organ donors 122 parental responsibility 45, 151, Caesarean section, refusal of consent 42, 161–162 47n, 130 Section 8 165 Canada, R v Cuerrier 219 China, AIDS 206 capacity 39–45 Circular HC(90)22 (Department of complexity of decisions and 40, 47n Health), on sterilisation 152 consent for sterilisation and 40–41, cirrhosis, viral hepatitis 205 151–152 Citizen’s Charter Task Force 71 living wills and 134 citric acid, supply 226 prisoners 25, 36 Civil Courts 7–8 terminal illness 142 civil detention orders 84–87 care orders, Children Act (1989) Civil Division of Court of Appeal 8 160–161, 162, 163–165 civil law 7 carers, disclosure of medical records to burden of proof 74 32–33 confidentiality claims 29 case co-ordinators, GMC performance negligence 167–170, 174 procedures 60–61 reports to court 237 case law 6–7 ‘claimant’ 175n causation claims, complaints vs 71 damage 171–172 clearance to perform Exposure Prone inference 172 Procedures 222 cause of death, death certificates Cleveland Report 159–160 34, 98 clinical governance 68, 72 CECOS, Parpalaix v 114 clinical negligence 167–177 centralised procedure clinical trials 193–201 EC Regulation 2309/93 183 stopping rules 196–197 proposed changes 187 cloning, tissue ownership and 109–110 Chancery division 8 Code of Conduct, Nursing & Midwifery chaperones, for prisoners 25 Council 66

244 INDEX

coercion, clinical trials and 199 healthcare professionals with blood- co-infection, HDV and HBV 205 borne viruses 222 Commission on Human Rights, United HIV status 212, 218 Nations 16 NHS complaint conciliation 78 Committee for Human Medicinal see also anonymity Products (CHMP) (EEC) 187 Confidentiality: protecting and providing see also European Agency for the information (General Medical Evaluation of Medicinal Products Council) 75 Committee for Proprietary Medicinal conjoined twins, autonomy 136n Products (CPMP) (EEC) 182 conscience, non-participation on Committee of Professional Performance grounds of, Abortion Act (1967) (CPP), GMC 61 150 Committee on Safety of Medicines consent (CSM) 181 clinical trials 196, 197 common law 6–7 disclosure of medical records to third communication, complaints and 73 parties and 32–37 community healthcare proxies 133–134, 143–144, care of mental patients 93–94 147n compulsory treatment in 91 Human Fertilisation and Embryology community-acquired infections, hepatitis Act (1990) 49n C virus 209 non-patient complainants 77 compensation organ donation 122 volunteers for clinical trials 198 for postmortem examinations 109 see also damages sterilisation, incapacity for 40–41, complainants, non-patient 77 151–152 complaints, reasons for 73–75 treatment 39–49 Complaints Managers 77 of detained patients 89–90 complaints procedures by forensic physicians 21, 23–25, General Medical Council 58–59 36 National Health Service 71–81 living wills and 128, 130, 134 confidentiality and 29, 34 treatment exceeding 48n complexity of decisions, capacity and 40, see also informed consent; refusal of 47n treatment compulsory testing, AIDS 211, 214, Consolidated Standards of Reporting 215 Trials (CONSORT) statement Concerned Member States (EC), mutual 199 recognition procedure 183 Consumer Protection Act (1987), concertation procedure, Directive European Union product liability 87/22/EEC 182, 183 Directive 189 conciliation, NHS complaints 78–79 contact with parents, Children Act conditional fees 175 (1989) 162 Conditional Organ Donation, contemporaneous notes 234, 235, 237 Investigation into (2000) 116n contemporaneous personal choice, conduct procedures, General Medical living wills and 127 Council 59–60 contraceptives 151–152 confidentiality 29–38 Gillick v West Norfolk and Wisbech biomedical ethics vs human rights AHA 151, 160 17–18 postcoital 149 children 33 contracts complaints and 75 breach, private practice 170 Data Protection Act (1998) and 31 for forensic physicians 23, 36 fertility treatment 153 Convenors, Independent Review Panels, forensic physicians and 21–22, 24, NHS complaints 79 25–26, 36 conversion, tort of 111

INDEX 245

convicted offenders, Mental Health Act AIDS-risk behaviour as 219 (1983) 88–89 General Medical Council 75 Corneal Grafting Act (1952) 106 see also specific offences corneal transplants 119 Criminal Procedure and Investigations coroners 95–104 Act (1996), ‘unused material’ 36 complaints procedures and 76 criminal proceedings, patients disclosure of clinical information to concerned in, Mental Health Act 37 (1983) 87–89 Coroners Act (1887) 96 criminal records, irrelevant information on juries 101 21 Coroners Act (1998) cross-examination 239–240 treasure trove 103 Crown Court 8 on unnatural deaths 100–103 detention of AIDS patient and 217 Coroner’s Courts 9, 238–239 giving evidence 239 Coroners Rules (1984), conduct of Mental Health Act (1983) inquests 101 Section 35 88 cost (expenditure), clinical negligence Section 41 89 litigation 175n Cruzan v Director, Missouri Department costs, legal 176n of Health 129, 133–134, 136n Council for Professions Supplementary cryopreservation, embryos 155 to Medicine (CPSM) 53 Cuerrier, R v 219 Councillors, Judicial Committee of the culpable homicide, case (Scotland) 74 Privy Council 8 cultural relativism 14–15 County Courts 7 custody, death in 98 Mental Health Act (1983) Section 3 custody officers, sharing information and 87–88 with 21, 36 court(s) custody records 26 Children Act (1989) 162 cuts, incision vs laceration 236 civil courts 7–8 cytotoxic drugs, spinal administration reports to 237 174 criminal courts 8–9 disclosure of clinical information to D 36–37 damage, negligence 171–172 healthcare professionals in 233–240 damages 173 parens patriae powers 48n, 134 see also compensation refusal of treatment 42 danger to life, disclosure of clinical see also specific courts information 35 Court of Appeal Data Protection Act (1998) 31–32 Civil Division 8 NHS complaints procedures and 75 R v Adamoko 174 Data Protection (Subject Access on right of access to medical records Modification) (Health) Order 30 (2000) 31 Court of Protection 134 death(s) Cox, R v 141, 146n from AIDS 217 Craig, Ann, AIDS infection case definition 122–123 218–219 role of coroner 96–103 cremation, blood-borne viruses and 217 on transplant waiting lists 117 Criminal Courts 8–9 see also euthanasia criminal law 7 death certificates 96–99 burden of proof 74 cause of death 34, 98 prosecution of doctors 173–174 recent inquiries 103 statements 233–237 death tourism 145 use for complaints 74 Declaration of Geneva, on criminal offences confidentiality 29

246 INDEX

Declaration of Helsinki 195 to patient 30–32 declaration of lawfulness 134 to third parties 32–37 Defective Medicines Reporting Centre discrimination 189–190 Suicide Act (1961) in Diane Pretty defective products 189 case 145 examples 190 (Table) see also non-discrimination deﬁnitions dispensing errors 191 Children Act (1989) 163 District Judges (Magistrate Court) 7 death 122–123 district registries 8 mental disorders 83 Divine Right of Kings 11 minors 48n Divisional Court of the Queen’s Bench 8 miscarriage 149 divorce, disclosure of medical records of delays, Children Act (1989) 162 children to parents 32–33 delegated legislation, England and DNA ‘theft’ 110, 115n Wales 2 doctors delict (Scotland) 71 appraisal 63–64 delta agent 205–206 clinical trials and 194 Department of Health with communicable diseases 221 blood-borne viruses, working practice duties 56–57 guidelines 220–225 forensic physicians 21–27, 36 haemophilia AIDS settlement 218 at inquests 102 Hepatitis C strategy for England 210 National Clinical Assessment Authority sterilisation, Circular HC(90)22 on (NCAA) 63 152 poll on refusal of consent 132 detention prosecution of 173–174 patients with BBV 216–217 revalidation 55, 64–66 at police stations, safety aspects 22 see also General Medical Council; psychiatry 19 occupational physicians disclosure of clinical information Donaldson, A.F. (Lord) 35–36 on consent 128 see also Mental Health Act Jehovah’s witness 136n see also custody of relatives 133 development of child, Children Act on self-ownership 128–129 (1989) 163 donations diagnosis, genetic, preimplantation body after death 111, 115n 156 eggs 153 Dignitas, assisted suicide 145 organs for transplantation 117–126 dimensions, in statements of evidence sperm 153 237 surrogate mothers 155 Director, Missouri Department of see also living organ donations Health, Cruzan v 129, 133–134, double effect (shortening life) 140, 136n 142–143 Director of Public Prosecutions, Diane Draft Mental Health Bill 92–93 Pretty case 144 dressing for court 238 disability discrimination, Suicide Act drugs (1961) in Diane Pretty case 145 misuse see intravenous drug users Disability Discrimination Act (1995), names 191 HIV infection 225 see also medicines disciplinary hearings, NHS 74 dual responsibilities discipline forensic physicians 22 complaints procedures vs 77–78 healthcare professionals 18–19 professional 51–69 occupational physicians 34 disclosure of clinical information duty/ies by forensic physicians 21 of doctors 56–57

INDEX 247

human rights and 12 ethnicity, organ availability 116n, to participate in clinical trials 194 118–119 duty of care 168 Europe neighbour test 175n organ exchange 119 duty to act, legal 143 organ transplantation statistics 124 Dworkin, Ronald, on euthanasia 139 (Table) European Agency for the Evaluation of E Medicinal Products (EMEA) 183 East Berkshire AHA, Hotson v 172 proposed changes 187 Egdell, W v 35–36 European Community see European eggs, donation 153 Union Egypt, hepatitis C virus (HCV) 209 European Convention on Human Rights electro-convulsive therapy 42, 48n 6, 13 Mental Health Act (1983) 90 assisted suicide 145 embryos sanctity of life 43 host surrogacy 155 see also Human Rights Act (1998) as property 113 European Court of Human Rights 13 research 152, 153 child care issues 160 sexing 156 psychiatric detention 19 storage 154 Z v Finland 18 EMEA see European Agency for the European Court of Justice 13 Evaluation of Medicinal on AIDS testing 214 Products European Economic Area, eligibility for emergency admission, Mental Health registration as doctors 56 Act (1983) European Union Section 4 85 legislation on pharmaceuticals Section 48 88 182–187 emergency detention of informal Directives 182, 185–186 (Table) patients, Mental Health Act Regulations 183, 186 (Table) 85–86 product liability Directive 189 emergency protection orders, Children euthanasia 139–147 Act (1989) 164 living wills and 127 emergency treatment withdrawal of treatment 43, 140, capacity to give consent 41 143–144, 147n children 45 evidence employers, disclosure of clinical inadmissible 238 information to 34 inquests 102 employment-related cause of death oral 237–240 absence 98 written 233–237 inquest verdicts 102 evidential standard of proof 167, 171 end-of-life decisions 139–147 examination in chief 239 Enduring Powers of Attorney Act (1985) expenditure, clinical negligence 133 litigation 175n entry warrants, Public Health (Infectious Exposure Prone Procedures (EPP) Diseases) Regulations (1985) 216 221–225 equipoise argument, clinical trials 194 express consent 47 errors of identiﬁcation, gametes 153 errors of medication 191 F Essex AHA, Wilsher v 170, 172 F v West Berkshire Health Authority (Re ethics, biomedical F) 40–41, 48n, 136n, 152 clinical trials 194–197 family care, Children Act (1989) 161 forensic physicians 21–27 Family Division 8 human rights vs 17–18 Family Health Service practices, ethics committees 197 complaints procedures 77

248 INDEX

Family Law Reform Act (1969), consent genetic diagnosis, preimplantation 156 and confidentiality 33, 43 Geneva Conventions 16 Fatal Accident Inquiries, complaints genito-urinary clinics, confidentiality 31 procedures and 76 Gillick competence 33, 44, 48–49n fertility treatment 113, 152–154 Gillick v West Norfolk and Wisbech Finland, Z v 18 AHA 151, 160 fitness-to-practise procedures ‘gist of the damage’ 171 doctors 57–59 ‘loss of a chance’ 172 Nursing & Midwifery Council 67 Glenochil Prison, AIDS outbreak 218–219 fluorescence in situ hybridisation Global Alliance for Vaccines and (FISH), embryo sexing 156 Immunisation (GAVI) 204 FME (forensic physicians) 21–27, 36 Global Fund for Children’s Vaccines 204 foetuses, legal loophole 109 GMC see General Medical Council food and hydration, withdrawal 131, 146 GMC (Fitness to Practise Committees) forensic physicians 21–27, 36 (Amendment) Rules Order of form of consent 47 Council (2002) 58 forum-shopping, Children Act (1989) GMC Health Committee (Procedure) and 162 Rules (1987) 61 foster parents, burial of children and GMC Preliminary Proceedings 115n Committee and Professional fracture complication (Hotson v East Conduct Committee (Procedure) Berkshire AHA) 172–173 Rules (1988) 59–60 Friern Hospital Management GMC (Professional Performance) Rules Committee, Bolam v see Bolam (1997) 60 test Goff, R.L.A (Lord) fulminant hepatitis, risk in viral hepatitis F v West Berkshire Health Authority 205 136n Fundamental Review into Death on prior refusal of consent 132 Certification and Investigation Good Medical Practice (publication) 65 103 Greece, euthanasia and 146n futility of treatment 43 grievous bodily harm 112 ‘Future Systems’ package (EC) 183 guardianship, Mental Health Act (1983) Section 7 87, 133 G Section 37 (convicted offenders) gametes 88–89 as property 113–114 Gwynedd County Council, ex parte storage 154 B, R v 115n General Medical Council 53–63 advance directives 43 H complaints to 74, 77 H, Re 164 confidentiality enforcement 29, 30 HAART (highly active anti-retroviral criminal offences 75 therapy) 214 documents haemophilia Confidentiality: protecting and AIDS settlement 218 providing information 75 hepatitis C virus (HCV) 209 Management in health care: the role of harm, Children Act (1989) 163–164 doctors 78 HBV see hepatitis B virus Withholding and withdrawing life- HC (Health Committee), General prolonging treatment 135 Medical Council 61, 62 see also titles beginning GMC … HCV see hepatitis C virus euthanasia case (Mrs L. Boyes) 141 HDV (hepatitis D virus) 205–206 Memoranda of Understanding 63 health general practitioners, complaints Children Act (1989) definition 163 procedures 77 right to 15–16

INDEX 249

Health and Social Care Act (2001), historical aspects, coroners 95–96 Health Service (Control of HIV (human immunodeficiency virus) Patient Information) Regulations 203, 206–208, 211–219 (2002) 34 healthcare professionals with Health Committee (HC), General 222–223, 224–225 Medical Council 61, 62 indications for testing 225 health procedures, General Medical X v Y 217–218 Council 61–62 legislative approaches compared Health Professions Council (HPC) 211–214 52–53 testing 214–215 health screeners, GMC 61 United Kingdom 208, 209 (Table) Health Service Commissioner advice to healthcare professionals (Ombudsman) see Parliamentary 220 Commissioner for Administration case law 218–219 Health Service (Control of Patient legal framework 215–218 Information) Regulations (2002) Z v Finland 18 34 Hofmann, J., on Swedish law on HIV healthcare professionals 213 AIDS risk 220 Holland see Netherlands blood-borne viruses, United Kingdom Home Secretary, Mental Health Act advice 220–225 powers over sentenced prisoners with communicable diseases 221 89 hepatitis B risk 204, 205 homicide see murder human rights and 17–19 homosexual/bisexual transmission, sharing of clinical information 33–34 AIDS, United Kingdom 208, 209 as witnesses 233–240 (Table) healthcare proxies 133–134, 143–144, hormone replacement therapy (HRT), 147n early stoppage of trial 197 heart-beating organ donors 122 Horseferry Road Justices, R v, ex parte Hecht v Kane 114 Independent Broadcasting hepatitis B ‘e’ antigen, Exposure Prone Authority 107 Procedures and 223 Hospital Orders, Mental Health Act hepatitis B surface antigen 203 (1983) Section 37 89 hepatitis B virus (HBV) 204–205 host surrogacy 155 guidelines specific to 223 Hotson v East Berkshire AHA 172 HDV and 205 House of Lords 8 protection of healthcare professionals doctrine of precedent and 7 220 Gillick case 151 hepatitis C virus (HCV) 209–211 on harm to children 164 healthcare professionals Hotson v East Berkshire AHA 173 infected with 224 Maynard v West Midlands Regional protection of 221 Health Authority 169 screening of blood transfusion Wilsher v Essex AHA 172 patients 218 Human bodies—human choices 119 hepatitis D virus (HDV) 205–206 Human Fertilisation and Embryology HFEA (Human Fertilisation and Act (1990) 113, 152 Embryology Authority) 113, amendment of Abortion Act (1967) 152–154 150 High Court 8 confidentiality 32 judicial review 5–6 Section 30 155–156 refusal of examination, children 164 sex selection 156 highly active anti-retroviral therapy written consent 49n (HAART) 214 Human Fertilisation and Embryology Hippocratic Oath, on confidentiality 18 Authority (HFEA) 113, 152–154

250 INDEX

Human Fertilisation and Embryology independent monitoring, clinical (Statutory Storage Period for trials 199 Embryos) Regulations (1996) 154 Independent Review Panels (IRPs), NHS human immunodeficiency virus see HIV complaints 79–80 Human Organ Transplants Act (1989) India, AIDS 206 112, 119, 120–121 industrial diseases see employment- Human Organ Transplants (unrelated related cause of death persons) Regulations (1989) 121 Infant Life (Preservation) Act (1929) human rights 11–16 149 healthcare professionals and 17–19 infection, surrogate mothers 155 HIV/AIDS 212 Infectious Disease (Notification) Act see also health 203 Human Rights Act (1998) 6, 13, 14 inference of causation 172 (box) infertility 152–154 children 161, 165–166 information on forensic care 23 Bolam test on 46, 137n hospitals retaining children’s tissues clinical trial participants 198–199 108 leaflets with medicines 191 mental health aspects 91–92 living wills and 133 organ donation and 119–120 sources, court evidence 236 unnatural deaths 100 sufficiency for consent to treatment Human Tissue Act (1961) 106 45–47, 137n organ donation 119, 120 see also disclosure of clinical organ removal 109 information consent of coroner 99 informed consent 46, 129 humanitarian law, international 16 clinical trials 196, 198–199 Hunt, Paul (UN Special Rapporteur on informed refusal of treatment 130 right to health) 16 inhumane and degrading treatment hydration, withdrawal 131, 146 43 hysterectomy, not for sterilisation 152 Inner North London Coroner, R (Touche) v 100 I inquests 9, 100–103 identified valid samples (IVS), blood- inquisitorial systems 9, 239, 240 borne virus testing 221–222 insemination, surrogate mothers 155 ill-treatment, Children Act (1989) instrumental model, HIV and the definition 163 law 212–213 immunisation, hepatitis B virus 204 insurance companies implantation, ovum 149 disclosure of clinical information implied consent 47 to 34 In re S; In re W 166 HIV tests and 227 in vitro fertilisation see host surrogacy; sex interferon-alpha, viral hepatitis 206 selection Interim Hospital Orders (Mental Health inadmissible evidence 238 Act 1983, Section 38) 88 incompatibility, declarations of, Human Interim Orders Committee, General Rights Act (1998) 6n Medical Council 62–63 independence, forensic physicians interim suspension 22–23 nurses and midwives 67 Independent Broadcasting Authority see also suspension of registration case (R v Horseferry Road International Committee of the Red Justices, ex parte Independent Cross 16 Broadcasting Authority) 107 International Conference on Independent Clinical Assessors, Harmonisation of Technical Independent Review Panels for Requirements for Registration of NHS complaints 80 Pharmaceuticals 195

INDEX 251

International Covenant on Civil and on living wills 132 Political Rights (ICCPR, 1966) 12 review of child law 160 International Covenant on Economic, lawfulness, declaration of 134 Social and Cultural Rights lay magistrates 7 (ICESCR, 1966) 12 lay terminology, statements of evidence right to health 15 236–237 international guidelines, clinical trials legal aid 175 194–195 legal duty to act 143 international humanitarian law (armed Legal Services Commission, ﬁnance of conﬂict) 16 justice 175 intravenous drug users (IVDU), blood- legislation (process) 1–2 borne viruses Legislative technique and human rights AIDS, United Kingdom 208, 209 (R. Tur) 147n (Table) Lenkiewicz, Robert, possession of body hepatitis C virus (HCV) 209–210 111 law on materials 225–227 Lennox-Wright, R v 107 Investigation into Conditional Organ liability Donation (2000) 116n product liability 188–191 ‘is suffering’, Children Act (1989) 164 vicarious 168 IVF (in vitro fertilisation) see host licences to practise (doctors) 64–65 surrogacy; sex selection licensing of medicines 187–188 ‘likely’, Children Act (1989), House of J Lords on 164 J, Re 128 Limitation Act (1980) 173 Jamieson case (R v North Humberside limitation periods 173, 176n Coroner, ex parte Jamieson) 101 see also time limits Janaway v Salford Health Authority 150 limited registration (doctors) 56 Jehovah’s Witnesses, advance directives Lindsay, R v 110 43, 136n litigation, complaints procedures and 78 Judicial Committee of the Privy living organ donations 112, 122 Council 8 Human Organ Transplants Act (1989) judicial law 6–7 on 121 judicial review 5–6 living wills 127–137 juries, inquests 100–101 criteria 132–133 Justices of the Peace, powers on as refusal of treatment 42–43 AIDS 216 vulnerability to abuse 130–131 local authorities, services, Children Act K (1989) 162 Kane, Hecht v 114 Locke, John 12 Keith, H.S. (Lord), in Bland case 131 locus standi 5 Kelly, R v 110 Lord Chief Justice, haemophilia AIDS Kelly, Stephen, AIDS infection 218–219 settlement 218 Kennedy, Ian (Professor), on retention ‘loss of a chance’ 172–173 of tissues by hospitals 108 knowledge of recent advances 170 M M, Re 164 L MacKenzie, Edwin, possession of body of Lancashire C.C. v B 164 111 law Magistrates’ Courts 7, 8 civil and criminal 7 Mental Health Act (1983) Section 35 judicial 6–7 88 sources 1–2 Magna Carta (1215) 11 Law Commission Malette v Shulman, Robins JA cited best interests principle 143 128–129

252 INDEX

Management in health care: the role of doctors medication errors 191 (General Medical Council) 78 medicines managers (administrators), disclosure of legislation 179–192 clinical information to 37 see also clinical trials Manchester, detention of AIDS patient Medicines Act (1968) 181–182 217 Medicines Commission 181–182 manslaughter 74 Medicines Control Agency (MCA) manufacturing issues, pharmaceuticals 187–188 189–190 Medicines Devices Agency (MDA) 188 marketing authorisations 179 Medicines for Human Use (Marketing presentation of applications 180 Authorisations Etc.) Regulations (Table) (1994) 183 Master of the Rolls Medicines Testing Scheme, MRHA judgement at R v North Humberside Inspection and Enforcement Coroner, ex parte Jamieson 102 Division 189 see also Donaldson, J.F. (Lord) Memoranda of Understanding, General materiality, information for consent to Medical Council 63 treatment 46–47 mental handicap Maynard v West Midlands Regional contraceptives and 151–152 Health Authority 169 sterilisation 40–41, 151–152 MB, Re 42, 130 see also mental impairment McGhee v NCB 172 Mental Health Act (1983) 83–94 McNair J, judgement in Bolam v Friern capacity 41–42 Hospital Management Committee consent of detained patients to 169 treatment 89–90 measurements, in statements of evidence Section 63 42, 90 237 Mental Health Act Commission 83–87 Medical Act (1858) 53 Mental Health (Patients in the Medical Act (1983) 53, 54 Community) Act (1995) 91 Schedule 4 60, 61 Mental Health Review Tribunals, rights Medical Act (1983) (Amendment of appeal to 91 (Table) Order) (2002) 54 mental illness Medical and Healthcare Regulatory capacity 41–42 Agency (MHRA) 188, 195 minors 44 Inspection and Enforcement Division community care 93–94 189 definition 83 medical defence organisations Human Rights Act (1998) 91–92 actions on confidentiality 32 psychopathic disorder, definition 83 advance directives 43 mental impairment effect of NHS Complaints Procedure definition 83 72 see also mental handicap medical ethics see ethics MHRA see Medical and Healthcare medical records Regulatory Agency contemporaneous notes 234, 235, 237 Ministers of Health 2, 3 disclosure to patient 30–32 minors disclosure to third parties 32–37 consent to medical treatment 43–45, presentation in court 239 128 Medical Referees, cause of death in definition 48n suspected AIDS 217 Gillick competence 33, 44, 48–49n Medical Research Council (MRC), on miscarriage, definition 149 clinical trials 196 misconduct Medical Treatment Act (1988) nurses & midwives 66–67 (Australia) 134 see also serious professional medical trespass (Australia) 134 misconduct (SPM)

INDEX 253

Missouri Department of Health case necessity for treatment (Cruzan v Director, Missouri Bolam test and 41 Department of Health) 129, emergencies 41 133–134, 136n needle stick exposure, hepatitis B virus Misuse of Drugs Act (1971), blood-borne risk 204 viruses and 225–226 negligence mixed sector complaints 75–76 cause of death 100 monitoring, clinical trials 199 clinical 167–177 Moore v Regents of the University of insufficiency of information for California 111–112, 115n consent to treatment 45 motor neurone disease 144–145 neighbour test, duty of care 175n Ms B (case), living wills 130, 133 neonates, anti-viral treatment, AIDS mucocutaneous exposure, AIDS prevention 208 transmission 208 Netherlands multi-handed trials 240 assisted suicide 144, 147n multiple pregnancy Winterwerp v, psychiatric detention from fertility treatment 154 19 selective termination 150 Youssef v 161 multi-state procedure (EEC) 182, 183 NHS and Primary Care Trusts (Sexually murder Transmitted Diseases) Directions derivation of word 96 (2000) 31 euthanasia as 140, 141 NHS Notification of Births and Deaths mutual recognition procedure, Regulations (1991) 34 European Community 183 NHS Venereal Diseases Regulations proposed changes 187 (1974) 31 NMC (Nursing & Midwifery Council) N 66–67 National Clinical Assessment Authority ‘no win no fee’ 175 (NCAA) 63 no-fault compensation 175, 177n National Health Service clinical trials 198 AIDS surveillance 215 Non Departmental Public Bodies clinical governance 68, 72 (NDPBs) 2 complaints procedures 34, 71–81 non-discrimination 17 confidentiality and 29, 34 prisoners and 23 defendant in negligence cases 168 non-heart-beating organ donors 122 flow of clinical information 34 non-participation on grounds of National Patient Safety Agency 191 conscience, Abortion Act (1967) organ donor register 121–122 150 Redress Scheme 177n non-voluntary euthanasia 140 staff grievances 76 Normanry, Presumption of 96 statutes see entries beginning NHS … North Humberside Coroner, R v, ex structure 2–6 parte Jamieson 101 UK Transplant 118, 121, 125 Northern Ireland, drug misuse law National Health Service (Venereal 227 Diseases) Regulations (1974) notes, contemporaneous 234, 235, 217–218 237 National Opinion Polls, Voluntary notifiable diseases 203 Euthanasia Society 146n AIDS 206 National Patient Safety Agency (NPSA) magistrates’ powers 216 191 notifications, statutory 34 national waiting lists for transplant Nuremberg Code 194–195 118–119 Nursing & Midwifery Council (NMC) natural deaths 99–100 66–67 NCB, McGhee v 172 Nursing & Midwifery Order (2001) 66

254 INDEX

O hospitals retaining children’s tissues O case (In Re O; In Re B), harm to child 108 164 refusal of treatment for child 45 oaths, in court 238 Parliament 1 occupational diseases Select Committees 3 blood-borne viruses 220–225 Sovereignty 1, 6 see also employment-related cause of Parliamentary Commissioner for death Administration (PCA) 4–5 occupational health role, forensic Health Service 71, 80 physicians 22 Parpalaix v CECOS 114 occupational physicians participation see non-participation on blood-borne viruses 221 grounds of conscience dual responsibilities 34 Partnership for Human Research offences, created by statutes 107 Participation (USA) 195 Offences Against the Person Act (1861) passive euthanasia 140 112 double effect (shortening life) 140, abortion 149 142–143 offenders, convicted, Mental Health Act withdrawal of food and hydration 131, (1983) 88–89 146 Ombudsman see Parliamentary withdrawal of treatment 43, 140, Commissioner for Administration 143–144, 147n omissions, written evidence 234 paternalism, self-determination vs 129, opinion polls see public attitude surveys 198 opinions, court evidence 236 patients opt out legislation, organ donation 122 with blood-borne viruses 216–218 Oregon, assisted suicide 144, 147n clinical trials and 194 organ donor register, National Health incorporation of preferences 199 Service 121–122 concerned in criminal proceedings, organs 105–116 Mental Health Act (1983) for transplantation 87–89 coroner’s consent 99 exposure to infected healthcare donation 117–126 professionals 223 racism and 116n medical records disclosure to 30–32 sale 112, 120–121 use of medicines 191 Osteopaths Act (1993) 52 see also Mental Health Act (1983) osteopathy, self-regulation 52 Paton v Trustees of BPAS and another ova (eggs), donation 153 150–151 PCA (Parliamentary Commissioner for P Administration) 4–5 PACE see Police and Criminal Evidence Health Service 71, 80 Act Pediatric AIDS Clinical Trials Group, Panelli J, Moore v Regents of the anti-viral preventive treatment University of California 111–112 208 parens patriae powers, courts 48n, 134 percutaneous exposure parental responsibility 45 AIDS transmission 208 Children Act (1989) 45, 151, 161–162 needle stick exposure, hepatitis B virus parents risk 204 burial of children 115n performance assessments 60 contraceptives and, Gillick v West performance procedures, General Norfolk and Wisbech AHA Medical Council 60–61 151, 160 persistent vegetative states (PVS) 43, disagreements on abortion 150–151 131, 136n, 143–144 disclosure of medical records of Pharmaceutical Committee, Directive children 32–33 75/320/EEC 182

INDEX 255

pharmaceuticals see clinical trials; private records, forensic physicians 26 medicines Privy Council pharmacovigilance 188 Judicial Committee 8 Phase I, II and III studies, drug reform of professional regulation 54 development 193 product liability 188–191 placenta, AIDS transmission, Africa 208 Professional Conduct Committee (PCC), ‘plaintiff’ 175n General Medical Council 59–60 police professional defence organisations see disclosure of clinical information to medical defence organisations 35–36 professional misconduct see misconduct; at medical consultations 25–26 serious professional misconduct volunteering information to 35, 36 (SPM) Police and Criminal Evidence Act professional regulating bodies 51–69 (PACE) see also registration bodies consent for samples 25 prohibited steps orders, Children Act prisoners’ choice of doctor 23 (1989) 165 Police Reform Act (2002), consent for proof blood samples 36 civil law vs criminal law 74 police stations 22 evidential standard of 167, 171 police surgeons (forensic physicians) proper officers, Public Health (Control 21–27, 36 of Disease) Act (1984) 217 postcoital contraceptives 149 property postimplantation sex selection 156 embryos as 113 postmortem examinations gametes as 113–114 consent for 109 human tissues as 109–114 natural death 99–100 in vivo 112–113 potassium chloride 141, 146n proscriptive model, HIV and the law powers of attorney 133 211, 213 Practice Managers, complaints about prosecutions 7 general practitioners 77 of doctors 173–174 pre-action protocols, on negligence 174 protective model, HIV and the law 212 precedent, doctrine of 7 protocols, on negligence 174 preconception sex selection 156 provisional registration, doctors 56 pregnancy proxies (healthcare proxies) 133–134, AIDS transmission prevention 214, 143–144, 147n 215 prudent patient test (USA) 46 Africa 208 psychiatry hepatitis C virus 210 in GMC health procedures 61 multiple 150, 154 human rights and 19 preimplantation genetic diagnosis 156 psychopathic disorder, definition 83 pre-registration period, doctors 56 psychosurgery 42 prescribing of medicines 190–191 public attitude surveys Prescription Only Medicines (Human euthanasia 139, 146n Use) Order (1997) 226 living wills 134–135, 137n Presumption of Normanry 96 organ donation 122 Pretty v United Kingdom 127, 135n, public authorities, Human Rights Act 144–145 (1998) and 6 prisoners see custody; detention Public Health (Control of Disease) Act privacy, prisoners 25 (1984) 34, 203, 216 private law, Children Act (1989) 165 proper officers 217 private practice Public Health (Infectious Diseases) breach of contract 170 Regulations (1985) 216 complaints 76 Public Health (Infectious Diseases) registration of doctors 55 Regulations (1988) 203, 216

256 INDEX

public inquiries 4 minors 44, 45 Public Interest Immunity 239 sanctity of life and 130, 136n public law, Children Act (1989) 163–164 see also living wills public places, Mental Health Act (1983) Regents of the University of California Section 136 86 Moore v 111–112, 115n publicity, of complaints procedures 76 Tarasoff v 35 p-values 193 register, Human Fertilisation and Embryology Authority 153 Q Registrars of Births and Deaths 97 qualifications see also Births and Deaths Registration for registration as doctors 56 Act (1953) witnesses to court 235 registration (professional) quality improvement systems, NHS 68 doctors 54–57 quantum 173 suspension 62–63 Queen’s Bench Division 8 nurses 66 registration bodies R on confidentiality 30 R (A minor: wardship consent to see also General Medical Council; medical treatment), Re 44, 128 professional regulating bodies R (Touche) v Inner North London Registration of Births and Deaths Coroner 100 Regulations (1987) 97 R v Adamoko 174 relatives R v Adams 142 consent for organ donation 122 R v Cox 141, 146n consent to treatment 133–134 R v Cuerrier 219 disclosure of medical records to R v Horseferry Road Justices, ex parte 32–33 Independent Broadcasting Mental Health Act (1983) Section 3 Authority 107 and 87–88 R v Kelly 110 release of witnesses 240 R v Lennox-Wright 107 remand to hospital for treatment, R v Lindsay 110 Mental Health Act (1983) Section R v North Humberside Coroner, ex 36 88 parte Jamieson 101 renal failure, transplantation 117 racism reports, to court 233–237 transplantation and 116n research see also ethnicity embryos 152, 153 randomised controlled clinical trials guidelines 195 (RCT) 193, 200 use of clinical information 37 reasonable man 176n see also clinical trials reasonable patient test (USA) 46 Responsible Medical Officers (RMOs), reasonable practice 169, 176n deputies, Mental Health Act recent advances, knowledge of 170 (1983) Section 5 86 records restricted detention orders, Mental forensic physicians 26 Health Act (1983) 89 see also medical records retrials 238 Red Cross 16 retrospective legislation, anonymity of Redress Scheme, National Health gamete donors 153 Service 177n revalidation, doctors 55, 64–66 refusal of examination, children, High rheumatoid arthritis case, Mrs Lilian Court 164 Boyes 141–142 refusal of treatment rights of audience 240 adults 42, 132, 137n, 141–142 risk behaviour, blood-borne viruses Caesarean section case 42, 47n, 130 218–219 informed 130 risk:benefit ratio 181

INDEX 257

risks of surgery, spinal cord, Sidaway v second opinions, Mental Health Act Bethlem Royal Governors and (1983) Section 57 90 Others 46, 136–137n Secretary of State for Health 2, 3 risks of treatment ‘Section 9’ statements 234 clinical trials 198–199 Select Committees, Parliament 3 information for consent 46–47 selective termination of pregnancy 150 Road Traffic Act (1988), disclosure of self-incrimination, inquests 102 name and address 35 self-ownership 128–130 Robins JA, Malette v Shulman, cited see also autonomy 128–129 self-regulation 52, 81 Rodriguez v A-G of British Columbia clinical governance 68, 72 145 see also professional regulating bodies Rose LJ: R v Kelly; R v Lindsay 110 semen see sperm Rousseau, Jean-Jacques 12 serious professional misconduct (SPM) Royal College of Surgeons, removal of 57, 59–60 body parts 110 confidentiality breach 30 Russell, J., judgment on detention of seriously deficient performance, doctors AIDS patient 217 58 severe mental impairment, definition 83 S sex selection 156 S (Adult: Refusal of Medical Treatment), sexing, embryos 156 Re 129, 134, 136n sexual abuse, children, Cleveland Report S and another, C and another v 150–151 159–160 S case (In re S; In re W) 166 sexual intercourse, AIDS transmission S, St George’s Healthcare Trust v 42 219 safety, forensic physicians 25–26 sexually transmitted diseases, Salford Health Authority, Janaway v 150 confidentiality 31 samples Shipman, Harold 95 blood-borne virus testing 221–222 Shipman Inquiry 103 AIDS 208 Shulman, Malette v: Robins JA cited consent, forensic physicians 24–25, 36 128–129 court evidence 236 Sidaway v Bethlem Royal Governors and sanctity of life Others 46, 136–137n European Convention on Human significant (term), Children Act (1989) Rights 43 163 property in organs vs 112 single market in pharmaceuticals, refusal of treatment and 130, 136n Directive 75/319/EEC 182 Scarman L: consent to clinical trials 197 Slapper, Gary (The Times), on DNA science, ethics 196–197 ‘theft’ 115n Scotland social services Adults with Incapacity (Scotland) Act disclosure of clinical information to (2000) 143 35 culpable homicide case 74 Mental Health Act (1983) Section 4 delict 71 85 drug misuse law 227 see also guardianship Gillick competence 44 South Africa, research guidelines 195 law on AIDS transmission 219 speaking, in court 238 law on incapacity 41 Special Rapporteur on right to health screeners (UN) 16 GMC health procedures 61–62 special risks, information for consent 47 GMC performance procedures 60 Specialist Register, General Medical screening (diagnostic) Council 56 hepatitis C virus 210 specific issue orders, Children Act HIV, compulsory 211 (1989) 165

258 INDEX

sperm T, Re (Adult: Refusal of Treatment) donation 153 (1993) 128 surrogate mothers 155 Tarasoff v Regents of the University of as property 113–114 California 35 storage 154 teaching, use of clinical information 37 spinal administration of cytotoxic drugs teenagers, consent to medical treatment 174 43–45 spinal cord, surgery risk (Sidaway case) termination of pregnancy (abortion) 46, 136–137n 149–151 SPM see serious professional misconduct grounds for 150 (Table) sporadic infections, hepatitis C virus 209 mental handicap (mother) 152 St George’s Healthcare Trust v S42 statutory notification 34 staff grievances, National Health Service terminology, statements of evidence 76 236–237 standard of care 168–170 terrorism, volunteering information to statements (written evidence) 233–237 police 35 statutory instruments 2 tetraplegia: B v A NHS Hospital Trust Statutory Medical Assessors, death 131 certification and 103 thalidomide 179 statutory notifications 34 The Times, on DNA theft 115n statutory tribunals 3 theft sterilisation, incapacity for consent DNA 110, 115n 40–41, 151–152 R v Kelly; R v Lindsay 110 stigmatisation, HIV infection 227 Therapeutic Goods Administration, stopping rules, clinical trials 196–197 Australia 195 storage therapeutic index 181 embryos 154 therapeutic role, forensic physicians cryopreservation 155 21–22 gametes 154 third parties, disclosure of medical strengths of drug preparations 191 records 32–37 substituted judgement, USA 43 time limits Suicide Act (1961) 144 complaints 77 suits (civil law) 7 Independent Review Panels 80 superinfection, HDV on HBV 205 see also limitation periods Surrogacy Act (1985) 156 tissues 105–116 surrogate decision makers (healthcare retention by hospitals 107–108, 119 proxies) 133–134, 143–144, see also organs 147n torts 71 surrogate mothers 113, 155–156 conversion 111 surveillance trespass against the person 112 AIDS Touche case (R (Touche) v Inner North National Health Service 215 London Coroner) 100 unlinked anonymous 208 transplantation see under organs medicines 193 Treasure Act (1996) 103 see also notifiable diseases treasure trove 102–103 suspension of registration, on health treatment grounds 62 by forensic physicians 21–22 Sweden, HIV and the law 213 Mental Health Act (1983) 86–87 Switzerland, assisted suicide 145 remand to hospital for 88 withdrawal 43, 140, 143–144, 147n T see also under consent; refusal of T, Re (Adult: Refusal of Medical treatment Treatment) (1992) 131, 133, trespass against the person 112 136n trespass, medical (Australia) 134

INDEX 259

trials (clinical) 193–201 USA stopping rules 196–197 informed consent 129 tribunals 3–4 Partnership for Human Research appeals against psychiatric detention Participation 195 19 reasonable patient test 46 Mental Health Review Tribunals, substituted judgement 43 rights of appeal to 91 (Table) see also Oregon Trustees of BPAS and another, Paton v 150–151 V Tur, R., Legislative technique and human vaccines, hepatitis B virus 204 rights 147n vasectomy, sperm storage 154 venereal diseases, conﬁdentiality 31 U ventilation (artiﬁcial), cessation 131 UK Transplant 118, 121, 125 verdicts, inquests 102 ultra vires action, judicial review of 5 vicarious liability 168 umbilical catheter, incorrect insertion viruses 170 load test, hepatitis B virus 223 ‘uncertain perpetrator’, harm to child see also blood-borne viruses 164 voluntary euthanasia 140 United Kingdom Voluntary Euthanasia Society, National blood-borne viruses, advice to Opinion Polls 146n healthcare professionals 220–225 volunteering information to police 35, HIV/AIDS 208, 209 (Table) 36 advice to healthcare professionals volunteers, clinical trials 198 220 case law 218–219 W legal framework 215–218 W (A Minor: Refusal of Treatment), Re medical bodies issuing research 136n guidelines 195 W case (In re S; In re W) 166 organ donation 123–125 W v Egdell 35–36 Pretty v 127, 135n, 144–145 waiting, at court 238 United Nations waiting lists, transplantation 117, 118 AIDS Epidemic Update December Wardlaw, Bonnington Castings v 172 2002 (WHO/UNAIDS) 206, 207 wards of court 48n, 134 (Table) warrants for entry, Public Health Commission on Human Rights 16 (Infectious Diseases) Regulations guidelines on human rights and (1985) 216 HIV/AIDS 212 wars, Geneva Conventions 16 Universal Declaration of Human welfare of child, Children Act (1989) Rights 12, 15 160–161 United States see USA West Berkshire Health Authority, F v Universal Declaration of Human Rights 40–41, 48n, 136n, 152 (UHDR, 1948) 12 West Midlands Regional Health on right to health 15 Authority, Maynard v 169 ‘unlicensed use’ of medicines 190–191 West Norfolk and Wisbech AHA, Gillick unlinked anonymous surveillance, AIDS v 151, 160 208 see also Gillick competence unnatural death 100–103 Wilsher v Essex AHA 170, 172 Unrelated Live Transplant Regulatory Winterwerp v Netherlands, psychiatric Authority (ULTRA) 121 detention 19 unrelated persons, live organ donors withdrawal of food and hydration 131, 121 146 ‘unused material’, Criminal Procedure withdrawal of treatment 43, 140, and Investigations Act (1996) 36 143–144, 147n

260 INDEX

Withholding and withdrawing life-prolonging World Medical Association, ethics of treatment (General Medical clinical trials 195 Council) 135 written evidence 233–237 witnesses, healthcare professionals as 233–240 X Women’s Health Initiative Study, early X v Y (on general practitioners with stoppage 197 AIDS) 217–218 Woolf Report, on negligence 174 word processors, written evidence Y 234–235 Youssef v The Netherlands 161 working practices, guidelines on blood- Youth Courts 9 borne viruses, Department of Health 220–225 Z World Health Organization, AIDS Z v Finland 18 Epidemic Update December 2002 (WHO/UNAIDS) 206, 207 (Table)