‘Hunger Strikes in Prison: The Legal Issues’, Conference Paper at conference, "Terence MacSwiney, Cork Men’s Gaol, and the Political Hunger Strike, 1920-2020", School of History, University College Cork, October 2020
Chapter 2
Contemporary
Ethical Dilemmas
No right is held more sacred, or is more carefully
guarded, by the common law, than the right of
every individual to the possession and control of
his own person, free from all restraint or
interference of others, unless by clear and
unquestioned authority of law.
—Union Pac. Ry. Co. v. Botsford
Learning Objectives (1 of 2)
• Describe various historical events that have had
an impact on the resolution of ethical dilemmas.
• Describe common ethical dilemmas and the
various ethical issues that have in many
instances divided many segments of the
population. Topics include:
– Abortion
– Sterilization
– Artificial insemination
Learning Objectives (2 of 2)
• Topics include:
– Surrogacy
– Organ donations
– Research, experimentation, and clinical
trials
– Human genetics
– Stem cell research
– AIDS
Ethical Dilemmas
• Ethical dilemmas arise in situations where a
choice must be made between unpleasant
alternatives.
• Occur when a choice involves giving up
something good and suffering some bad.
– Should I choose life knowing an unborn child
will be born with severe disabilities?
Noteworthy Historical Events (1 of 11)
58,000–68,000 BC: Neanderthal burial sites
(evidence of belief in an afterlife)
1932–1972: Tuskegee Study of Syphilis
1933–1945: Holocaust
1946: Military Tribunal for War Crimes
1949: International Code of Medical Ethics
1954: Guidelines on Human Experimentation
First kidney transplant
Noteworthy Historical Events (2 of 11)
1960s: Cardiopulmonary resuscitation
1964: WHO guidelines for biomedical research
1968: Harvard Ad Hoc Committee on Brain Death
1970: Patient as a Person
1971: Kennedy Institute of Ethics established
1972: Informed consent (Canterbury v. Spence)
1973: Women’s right to abortion (Roe v. Wade)
Noteworthy Historical Events (4 of 11)
1974: National Research Act
1975: First successful cloning of frogs
1976: Substitute judgment (Karen Ann Quinlan)
First living will legislation enacted
1978: Commission for the Study of Ethical
Problems in Medicine
Noteworthy Historical Events (5 of 11)
1980: Hemlock Society formed to advocate for
physician-assisted dying.
1983: First durable power of attorney legislation
Compassion and Choices
1987: Unethical experiments on children
Noteworthy Historical Events (6 of 11)
1990: Patient Self-Determination Act
Cruzan could have feeding tube removed
Kevorkian assists terminally ill patients in
suicide
Timothy Quill and prescription for death
Derek Humphry’s book Final Exit
Radiation experiments on unknowing
human
subjects
Noteworthy Historical Events (7 of 11)
1993: Patient’s wishes honored
1994: Oregon’s Death with Dignity Act
Michigan makes physician-assisted suicide
illegal
1996: HIPAA
Cloning of Dolly
Fourteenth Amendment and the terminally ill
Noteworthy Historical Events (8 of 11)
1997: Physician-assisted suicide
Kevorki ...
Deprivation of liberty in an acute medical setting - Ferreira v Coroner of In...Browne Jacobson LLP
In Ferreira v Coroner of Inner South London (26 January 2017) the Court of Appeal delivered a landmark judgment on deprivation of liberty in the context of acute medical treatment that will be very welcome for providers of physical healthcare.
Chapter 2
Contemporary
Ethical Dilemmas
No right is held more sacred, or is more carefully
guarded, by the common law, than the right of
every individual to the possession and control of
his own person, free from all restraint or
interference of others, unless by clear and
unquestioned authority of law.
—Union Pac. Ry. Co. v. Botsford
Learning Objectives (1 of 2)
• Describe various historical events that have had
an impact on the resolution of ethical dilemmas.
• Describe common ethical dilemmas and the
various ethical issues that have in many
instances divided many segments of the
population. Topics include:
– Abortion
– Sterilization
– Artificial insemination
Learning Objectives (2 of 2)
• Topics include:
– Surrogacy
– Organ donations
– Research, experimentation, and clinical
trials
– Human genetics
– Stem cell research
– AIDS
Ethical Dilemmas
• Ethical dilemmas arise in situations where a
choice must be made between unpleasant
alternatives.
• Occur when a choice involves giving up
something good and suffering some bad.
– Should I choose life knowing an unborn child
will be born with severe disabilities?
Noteworthy Historical Events (1 of 11)
58,000–68,000 BC: Neanderthal burial sites
(evidence of belief in an afterlife)
1932–1972: Tuskegee Study of Syphilis
1933–1945: Holocaust
1946: Military Tribunal for War Crimes
1949: International Code of Medical Ethics
1954: Guidelines on Human Experimentation
First kidney transplant
Noteworthy Historical Events (2 of 11)
1960s: Cardiopulmonary resuscitation
1964: WHO guidelines for biomedical research
1968: Harvard Ad Hoc Committee on Brain Death
1970: Patient as a Person
1971: Kennedy Institute of Ethics established
1972: Informed consent (Canterbury v. Spence)
1973: Women’s right to abortion (Roe v. Wade)
Noteworthy Historical Events (4 of 11)
1974: National Research Act
1975: First successful cloning of frogs
1976: Substitute judgment (Karen Ann Quinlan)
First living will legislation enacted
1978: Commission for the Study of Ethical
Problems in Medicine
Noteworthy Historical Events (5 of 11)
1980: Hemlock Society formed to advocate for
physician-assisted dying.
1983: First durable power of attorney legislation
Compassion and Choices
1987: Unethical experiments on children
Noteworthy Historical Events (6 of 11)
1990: Patient Self-Determination Act
Cruzan could have feeding tube removed
Kevorkian assists terminally ill patients in
suicide
Timothy Quill and prescription for death
Derek Humphry’s book Final Exit
Radiation experiments on unknowing
human
subjects
Noteworthy Historical Events (7 of 11)
1993: Patient’s wishes honored
1994: Oregon’s Death with Dignity Act
Michigan makes physician-assisted suicide
illegal
1996: HIPAA
Cloning of Dolly
Fourteenth Amendment and the terminally ill
Noteworthy Historical Events (8 of 11)
1997: Physician-assisted suicide
Kevorki ...
Deprivation of liberty in an acute medical setting - Ferreira v Coroner of In...Browne Jacobson LLP
In Ferreira v Coroner of Inner South London (26 January 2017) the Court of Appeal delivered a landmark judgment on deprivation of liberty in the context of acute medical treatment that will be very welcome for providers of physical healthcare.
Our medical treatment and the courts seminar in partnership with 39 Essex Chambers covered the following topics:
- medical treatment & the courts – autonomy v paternalism
- end of life decisions
- the role of family in decision making
- deprivation of liberty in hospital.
For further information and resources visit our website - https://www.brownejacobson.com/health
For our July claims clubs we look at the changing public sector claims profile and insurance market, and give you the information you need to keep on top of the changes.
For our July claims clubs we look at the changing public sector claims profile and insurance market, and give you the information you need to keep on top of the changes.
History of bioethics describes the evolution of medical ethics over centuries and the reasons for introduction of various ethical decelerations and codes.
Chapter 15
End-of-Life Issues
LEARNING OBJECTIVES
• Discuss the human struggle to survive and the
right to autonomous decision-making.
• Describe how patient autonomy has been
impacted by case law and legislative enactments.
• Discuss the following concepts: preservation of
life with limits, euthanasia, advance directives,
futility of treatment, withholding and withdrawal
of treatment, and do-not-resuscitate orders.
LEARNING OBJECTIVES – II
• Discuss the purpose of an ethics committee
and its consultative role in the delivery of
patient care.
• Explain end-of-life issues as they relate to
autopsy, organ donations, research
experimentation, and clinical trials.
• Describe how human genetics and stem cell
research can have an impact on end-of-life
issues.
Dreams of Immortality
• Human struggle to survive
• Desire to prevent & cure illness
• Advances in medicine & power to prolong life
• Process of dying can be prolonged
• Ethical & legal issues have increased
– involving entire life span, from right to be
born to right to die
Scope of Ethical Issues
• Entire Life Span
• The Right to be Born
• The Right to Die, &
• Everything in between, e.g.,
– to choose treatment
– to refuse treatment for oneself
– to refuse treatment for another
– to limit the suffering one would endure
Ethical Dilemmas Arise
When values,
rights,
duties
& loyalties conflict.
Autonomy
• Right of a person to make one’s own decisions.
• Patient has right to accept or refuse care even
if it is beneficial to saving his or her life.
• Autonomy may be inapplicable in certain
cases
– affected by one’s disabilities, mental status,
maturity, or capacity to make decisions.
Quinlan court
Relying on: Roe v. Wade
• Announced the constitutional right to privacy
protects a patient’s right to self-
determination.
• State’s interest did not justify interference
with her right to refuse treatment.
• Quinlan’s father was appointed her legal
guardian
Cruzan Case
• Supreme Court held that right-to-die should be
decided pursuant to state law, subject to a due-
process liberty interest, and in keeping with state
constitutional law.
• Cruzans returned to Missouri probate court:
– Judge Charles Teel authorized physicians to
remove the feeding tubes from Nancy.
– testimony presented demonstrated clear &
convincing evidence Nancy would not have
wanted to live in a persistent vegetative state.
Legislative Response: Patient Self-
Determination Act of 1990
• Requires healthcare organizations to explain
to patients their legal right to direct their own
care
• Right to refuse medical treatment
• Right to formulate advance directives
• Right to appoint surrogate decision-maker
• Federal reimbursement requires compliance
with Act
Preservation of Life
• Medical ethics does not require patient’s life
be preserved at all cost under all
circumstances.
• Ethical integrity
– of a profession is not compromis.
Module 5 Euthanasia, Physician Assisted Suicide and The Righ.docxkendalfarrier
Module 5
Euthanasia, Physician Assisted Suicide and The Right to Die
Movement
Key Terms
• Hippocratic Oath – an ancient, optional code of ethical
principles
• Euthanasia – intentional shortening of the life of a person
or animal to spare further suffering
• Active Euthanasia – taking some action to cause
death
• Passive Euthanasia – withholding treatment that
might prolong life (generally tolerated by society)
• Key question: Should actions be introduced,
continued, done, or discontinued?
Key Terms
• Terminal Sedation – relieving dying patients’ distress by
keeping them in a deep sedation or coma until death
• An alternative to active euthanasia
• Called “slow euthanasia”
• Liberty Principle – individuals can make their own
decisions
• Informed Consent – patients must be fully informed
before proceeding with treatments
• Competence – the mental ability to understand the
information and make a rational decision
Key Terms
• Nazi “euthanasia” – the false name given to the murder
of innocent people and associated genocide
• Black Stork – The movement in the U.S. in the early
1900s to allow “defective” infants to die
• Eugenics – The movement aimed at sterilizing people
with “defective genes”
• Led to other ideas, such as letting “defective” infants die and
ending the lives of “incurable” patients
• Slippery Slope Argument – Opposing any instance of
assisted death because it could contribute to widespread
abuse in other instances
Assisted Suicide and Euthanasia
• In both, at least two individuals are involved.
• In Assisted Suicide, permission and
cooperation is obtained from individual
wishing to end life. Not always the case in
euthanasia.
Euthanasia and Religion
Various Religions have commented on Euthanasia
and other forms of assisted Suicide:
Judaism: God created a person and therefore
owns the body, a person is just the caretaker
Duty to preserve life – Orthodox & Conservative
Jews find euthanasia morally unacceptable
Active Euthanasia is condemned by all Jewish
groups
Euthanasia in Christianity & Islam
Christianity: suffering is part of God’s plan for
all humans
Typically oppose any intentional killing of
oneself or others
Islam: Suicide, Euthanasia and Physician
Assisted Suicide is generally disapproved of
“Do not destroy yourselves”
Euthanasia Hinduism & Buddhism
Hinduism: assisted suicide and euthanasia may
interfere with karmic processes and is undesirable,
but is not forbidden
Extending human life through medical interventions
may also interfere with karma
Ahimsa: avoidance of causing pain or killing any life
Gandhi: “Should my child be attacked with rabies and
there was no helpful remedy to relieve his agony, I
should consider ot my duty to end his life”
Buddhism: intentionally ending a life is unacceptable
Easing suffering is inappropriate
Right-To-Die Cases
• Estimated that 10,000 to 35.
Ethical and Human Rights Concerns in Global HealthChapter Fou.docxdebishakespeare
Ethical and Human Rights Concerns in Global Health
Chapter Four
Chapter four: Ethical and human rights concerns in global health.
As with any area of health, global health is affected by the issues of ethics and right for sound health outcome. In this chapter we will explore ethical and human rights concerns, some of the central treaties and conversions related to human rights, some historically significant cases in human subject research and key principles for making critical decisions in health research.
1
Failure to respect human rights is often associated with harm to human health
Health research with human subjects puts people at risk for the sake of other people’s health
Health investments must be made in fair ways since resources are limited
The Importance of Ethical and Human Rights Issues in Global Health
Access to the health care is human right and failure to respect this right might causes harm for health. For example, the stigma associated with HIV, TB and leprosy makes it difficult for the patient to obtain necessary health care, it not only cause harm to individual health but as a whole community health even. For example, if a TB patient remains untreated by the health care workers, then that individual could be a source of infection for other people.
Health research with human subject in particular in low income countries where study participants may not have other option to obtain the medication might become a proxy of clinical trial for other people .Lastly, fair decision in health investment is critical because in low income countries where health resources are scare difficult decisions need to be made depending on the priority and severity of disease.
2
The Foundations for Health and Human Rights
Universal Declaration of Human Rights and other legally binding multilateral treaties
Governments are obliged to respect, protect, and fulfill the rights they state
International Bill of Human Rights is the cornerstone for human rights. This bill include couple of documents including the Universal declaration of human rights that was officially declared in 1948, that place obligation on Government to respect , protect, and fulfill the rights of the state.
3
Selected Human Rights
The Rights-Based Approach
Assess health policies, programs, and practices in terms of impact on human rights
Analyze and address the health impacts resulting from violations of human rights when considering ways to improve population health
Prioritize the fulfillment of human rights
In considering human right, first we are going to examine the issue of right based approach. Some global health advocates argue that this approach, which thinks that fulfillment of people’s human right is conducive to their health, should be followed in global health. This means we need to assess health policies, programs or practices in terms of its impact on human right and analyze the health impacts from the perspective of violation of human rights
.
Chapter 17End-of-Life IssuesWhen we finally know we are EstelaJeffery653
Chapter 17
End-of-Life Issues
When we finally know we are dying,
And all other sentient beings are dying with us,
We start to have a burning,
almost heart-breaking sense
of the fragility and preciousness of each moment and each being,
and from this can grow
a deep, clear, limitless compassion for all beings.
—Sogyal Rinpoche
Learning Objectives
Discuss the human struggle to survive and the right to autonomous decision making.
Describe how patient autonomy has been impacted by case law and legislative enactments.
Discuss the following concepts: preservation of life with limits, euthanasia, advance directives, futility of treatment, withholding and withdrawal of treatment, and do-not-resuscitate orders.
Learning Objectives, cont’d
Explain end-of-life issues as they relate to autopsy, organ donations, research, experimentation, and clinical trials.
Describe how human genetics and stem cell research can have an impact on end-of-life issues.
Dreams of Immortality
Human Struggle to Survive
Desire to Prevent & Cure Illness
Advances in Medicine & Power to Prolong Life
Ethical & Legal Issues
Involving entire life span
From right to be born to right to die
Patient Autonomy
Right to make one’s own decisions
Patient has the right to accept or refuse care even if it is beneficial to saving his or her life.
Autonomy may be inapplicable in certain cases.
Affected by one’s disabilities, mental status, maturity, or incapacity to make decisions
No right is held more sacred, or is more carefully guarded, by the common law, than the right of every individual to the possession and control of his own person, free from all restraint or interference of others, unless by clear and unquestioned authority of law.
—Union Pac. Ry. Co. v. Botsford (1891)
Every human being of adult years and sound mind has a right to determine what shall be done with his own body and a surgeon who performs an operation without his patient’s consent commits an assault, for which he is liable in damages, except in cases of emergency where the patient is unconscious and where it is necessary to operate before consent can be obtained.
—Schloendorff v. Society of New York Hospital (1914)
Why Courts Get Involved
End-of-Life Issues
Family members disagree as to the incompetent’s wishes.
Physicians disagree on the prognosis.
A patient’s wishes are unknown because he or she has always been incompetent.
Evidence exists of wrongful motives or malpractice.
In re Quinlan (1976)
Constitutional right to privacy protects patient’s right to self-determination.
A state’s interest does not justify interference with one’s right to refuse treatment.
In re Storar (1981)
Every human being of adult years and sound mind has the right to determine what shall be done with his or her own body.
Superintendent of Belchertown State School v. Saikewicz (1977)
Saikewicz allowed to refuse treatment.
Questions of life and death with regard to an incompetent ...
Mental Health Act 2001 Toolkit Launch 10 Nov 2022Darius Whelan
The School of Law, University College Cork, has developed a Mental Health Act Toolkit in partnership with Mental Health Reform.
When people with mental health difficulties are admitted to mental health units, either on a voluntary or involuntary basis, it is vital that user-friendly, accessible, information is available regarding human rights. Access to this information is essential for people with mental health difficulties, their family members, advocates, supporters and carers. The Mental Health Act 2001 Toolkit is published on Mental Health Reform’s website.
Video of launch: https://youtu.be/cXOfqiMz77A
Toolkit:
https://www.mentalhealthreform.ie/mental-health-act-2001-toolkit/
Funded by the Irish Research Council.
More Related Content
Similar to Hunger Strikes in Prison: The Legal Issues Oct 2020
Our medical treatment and the courts seminar in partnership with 39 Essex Chambers covered the following topics:
- medical treatment & the courts – autonomy v paternalism
- end of life decisions
- the role of family in decision making
- deprivation of liberty in hospital.
For further information and resources visit our website - https://www.brownejacobson.com/health
For our July claims clubs we look at the changing public sector claims profile and insurance market, and give you the information you need to keep on top of the changes.
For our July claims clubs we look at the changing public sector claims profile and insurance market, and give you the information you need to keep on top of the changes.
History of bioethics describes the evolution of medical ethics over centuries and the reasons for introduction of various ethical decelerations and codes.
Chapter 15
End-of-Life Issues
LEARNING OBJECTIVES
• Discuss the human struggle to survive and the
right to autonomous decision-making.
• Describe how patient autonomy has been
impacted by case law and legislative enactments.
• Discuss the following concepts: preservation of
life with limits, euthanasia, advance directives,
futility of treatment, withholding and withdrawal
of treatment, and do-not-resuscitate orders.
LEARNING OBJECTIVES – II
• Discuss the purpose of an ethics committee
and its consultative role in the delivery of
patient care.
• Explain end-of-life issues as they relate to
autopsy, organ donations, research
experimentation, and clinical trials.
• Describe how human genetics and stem cell
research can have an impact on end-of-life
issues.
Dreams of Immortality
• Human struggle to survive
• Desire to prevent & cure illness
• Advances in medicine & power to prolong life
• Process of dying can be prolonged
• Ethical & legal issues have increased
– involving entire life span, from right to be
born to right to die
Scope of Ethical Issues
• Entire Life Span
• The Right to be Born
• The Right to Die, &
• Everything in between, e.g.,
– to choose treatment
– to refuse treatment for oneself
– to refuse treatment for another
– to limit the suffering one would endure
Ethical Dilemmas Arise
When values,
rights,
duties
& loyalties conflict.
Autonomy
• Right of a person to make one’s own decisions.
• Patient has right to accept or refuse care even
if it is beneficial to saving his or her life.
• Autonomy may be inapplicable in certain
cases
– affected by one’s disabilities, mental status,
maturity, or capacity to make decisions.
Quinlan court
Relying on: Roe v. Wade
• Announced the constitutional right to privacy
protects a patient’s right to self-
determination.
• State’s interest did not justify interference
with her right to refuse treatment.
• Quinlan’s father was appointed her legal
guardian
Cruzan Case
• Supreme Court held that right-to-die should be
decided pursuant to state law, subject to a due-
process liberty interest, and in keeping with state
constitutional law.
• Cruzans returned to Missouri probate court:
– Judge Charles Teel authorized physicians to
remove the feeding tubes from Nancy.
– testimony presented demonstrated clear &
convincing evidence Nancy would not have
wanted to live in a persistent vegetative state.
Legislative Response: Patient Self-
Determination Act of 1990
• Requires healthcare organizations to explain
to patients their legal right to direct their own
care
• Right to refuse medical treatment
• Right to formulate advance directives
• Right to appoint surrogate decision-maker
• Federal reimbursement requires compliance
with Act
Preservation of Life
• Medical ethics does not require patient’s life
be preserved at all cost under all
circumstances.
• Ethical integrity
– of a profession is not compromis.
Module 5 Euthanasia, Physician Assisted Suicide and The Righ.docxkendalfarrier
Module 5
Euthanasia, Physician Assisted Suicide and The Right to Die
Movement
Key Terms
• Hippocratic Oath – an ancient, optional code of ethical
principles
• Euthanasia – intentional shortening of the life of a person
or animal to spare further suffering
• Active Euthanasia – taking some action to cause
death
• Passive Euthanasia – withholding treatment that
might prolong life (generally tolerated by society)
• Key question: Should actions be introduced,
continued, done, or discontinued?
Key Terms
• Terminal Sedation – relieving dying patients’ distress by
keeping them in a deep sedation or coma until death
• An alternative to active euthanasia
• Called “slow euthanasia”
• Liberty Principle – individuals can make their own
decisions
• Informed Consent – patients must be fully informed
before proceeding with treatments
• Competence – the mental ability to understand the
information and make a rational decision
Key Terms
• Nazi “euthanasia” – the false name given to the murder
of innocent people and associated genocide
• Black Stork – The movement in the U.S. in the early
1900s to allow “defective” infants to die
• Eugenics – The movement aimed at sterilizing people
with “defective genes”
• Led to other ideas, such as letting “defective” infants die and
ending the lives of “incurable” patients
• Slippery Slope Argument – Opposing any instance of
assisted death because it could contribute to widespread
abuse in other instances
Assisted Suicide and Euthanasia
• In both, at least two individuals are involved.
• In Assisted Suicide, permission and
cooperation is obtained from individual
wishing to end life. Not always the case in
euthanasia.
Euthanasia and Religion
Various Religions have commented on Euthanasia
and other forms of assisted Suicide:
Judaism: God created a person and therefore
owns the body, a person is just the caretaker
Duty to preserve life – Orthodox & Conservative
Jews find euthanasia morally unacceptable
Active Euthanasia is condemned by all Jewish
groups
Euthanasia in Christianity & Islam
Christianity: suffering is part of God’s plan for
all humans
Typically oppose any intentional killing of
oneself or others
Islam: Suicide, Euthanasia and Physician
Assisted Suicide is generally disapproved of
“Do not destroy yourselves”
Euthanasia Hinduism & Buddhism
Hinduism: assisted suicide and euthanasia may
interfere with karmic processes and is undesirable,
but is not forbidden
Extending human life through medical interventions
may also interfere with karma
Ahimsa: avoidance of causing pain or killing any life
Gandhi: “Should my child be attacked with rabies and
there was no helpful remedy to relieve his agony, I
should consider ot my duty to end his life”
Buddhism: intentionally ending a life is unacceptable
Easing suffering is inappropriate
Right-To-Die Cases
• Estimated that 10,000 to 35.
Ethical and Human Rights Concerns in Global HealthChapter Fou.docxdebishakespeare
Ethical and Human Rights Concerns in Global Health
Chapter Four
Chapter four: Ethical and human rights concerns in global health.
As with any area of health, global health is affected by the issues of ethics and right for sound health outcome. In this chapter we will explore ethical and human rights concerns, some of the central treaties and conversions related to human rights, some historically significant cases in human subject research and key principles for making critical decisions in health research.
1
Failure to respect human rights is often associated with harm to human health
Health research with human subjects puts people at risk for the sake of other people’s health
Health investments must be made in fair ways since resources are limited
The Importance of Ethical and Human Rights Issues in Global Health
Access to the health care is human right and failure to respect this right might causes harm for health. For example, the stigma associated with HIV, TB and leprosy makes it difficult for the patient to obtain necessary health care, it not only cause harm to individual health but as a whole community health even. For example, if a TB patient remains untreated by the health care workers, then that individual could be a source of infection for other people.
Health research with human subject in particular in low income countries where study participants may not have other option to obtain the medication might become a proxy of clinical trial for other people .Lastly, fair decision in health investment is critical because in low income countries where health resources are scare difficult decisions need to be made depending on the priority and severity of disease.
2
The Foundations for Health and Human Rights
Universal Declaration of Human Rights and other legally binding multilateral treaties
Governments are obliged to respect, protect, and fulfill the rights they state
International Bill of Human Rights is the cornerstone for human rights. This bill include couple of documents including the Universal declaration of human rights that was officially declared in 1948, that place obligation on Government to respect , protect, and fulfill the rights of the state.
3
Selected Human Rights
The Rights-Based Approach
Assess health policies, programs, and practices in terms of impact on human rights
Analyze and address the health impacts resulting from violations of human rights when considering ways to improve population health
Prioritize the fulfillment of human rights
In considering human right, first we are going to examine the issue of right based approach. Some global health advocates argue that this approach, which thinks that fulfillment of people’s human right is conducive to their health, should be followed in global health. This means we need to assess health policies, programs or practices in terms of its impact on human right and analyze the health impacts from the perspective of violation of human rights
.
Chapter 17End-of-Life IssuesWhen we finally know we are EstelaJeffery653
Chapter 17
End-of-Life Issues
When we finally know we are dying,
And all other sentient beings are dying with us,
We start to have a burning,
almost heart-breaking sense
of the fragility and preciousness of each moment and each being,
and from this can grow
a deep, clear, limitless compassion for all beings.
—Sogyal Rinpoche
Learning Objectives
Discuss the human struggle to survive and the right to autonomous decision making.
Describe how patient autonomy has been impacted by case law and legislative enactments.
Discuss the following concepts: preservation of life with limits, euthanasia, advance directives, futility of treatment, withholding and withdrawal of treatment, and do-not-resuscitate orders.
Learning Objectives, cont’d
Explain end-of-life issues as they relate to autopsy, organ donations, research, experimentation, and clinical trials.
Describe how human genetics and stem cell research can have an impact on end-of-life issues.
Dreams of Immortality
Human Struggle to Survive
Desire to Prevent & Cure Illness
Advances in Medicine & Power to Prolong Life
Ethical & Legal Issues
Involving entire life span
From right to be born to right to die
Patient Autonomy
Right to make one’s own decisions
Patient has the right to accept or refuse care even if it is beneficial to saving his or her life.
Autonomy may be inapplicable in certain cases.
Affected by one’s disabilities, mental status, maturity, or incapacity to make decisions
No right is held more sacred, or is more carefully guarded, by the common law, than the right of every individual to the possession and control of his own person, free from all restraint or interference of others, unless by clear and unquestioned authority of law.
—Union Pac. Ry. Co. v. Botsford (1891)
Every human being of adult years and sound mind has a right to determine what shall be done with his own body and a surgeon who performs an operation without his patient’s consent commits an assault, for which he is liable in damages, except in cases of emergency where the patient is unconscious and where it is necessary to operate before consent can be obtained.
—Schloendorff v. Society of New York Hospital (1914)
Why Courts Get Involved
End-of-Life Issues
Family members disagree as to the incompetent’s wishes.
Physicians disagree on the prognosis.
A patient’s wishes are unknown because he or she has always been incompetent.
Evidence exists of wrongful motives or malpractice.
In re Quinlan (1976)
Constitutional right to privacy protects patient’s right to self-determination.
A state’s interest does not justify interference with one’s right to refuse treatment.
In re Storar (1981)
Every human being of adult years and sound mind has the right to determine what shall be done with his or her own body.
Superintendent of Belchertown State School v. Saikewicz (1977)
Saikewicz allowed to refuse treatment.
Questions of life and death with regard to an incompetent ...
Mental Health Act 2001 Toolkit Launch 10 Nov 2022Darius Whelan
The School of Law, University College Cork, has developed a Mental Health Act Toolkit in partnership with Mental Health Reform.
When people with mental health difficulties are admitted to mental health units, either on a voluntary or involuntary basis, it is vital that user-friendly, accessible, information is available regarding human rights. Access to this information is essential for people with mental health difficulties, their family members, advocates, supporters and carers. The Mental Health Act 2001 Toolkit is published on Mental Health Reform’s website.
Video of launch: https://youtu.be/cXOfqiMz77A
Toolkit:
https://www.mentalhealthreform.ie/mental-health-act-2001-toolkit/
Funded by the Irish Research Council.
Copyright for Digital Learning
Darius Whelan
Irish Universities Association - Enhancing Digital Teaching and Learning in Irish Universities - Online Seminar, June 2020
Link to resources cited:
https://bit.ly/copyright_open_IUADigEd_June2020
Employees and Internet Use - Legal PerspectiveDarius Whelan
E Law Developments: Employees and Internet Use
Southern Law Association event, Cork, September 2019
Darius Whelan, School of Law, UCC
IT Law Clinic
http://www.ucc.ie/law/courses/
E Law Developments: Copyright Law
Southern Law Association event, Cork, September 2019
Darius Whelan, School of Law, UCC
IT Law Clinic
https://www.ucc.ie/en/law/courses/
LLM in Intellectual Property and E Law, University College Cork, IrelandDarius Whelan
LLM in Intellectual Property and E Law, University College Cork
School of Law
https://www.ucc.ie/en/lawsite/ucc-master's-law/
https://www.ucc.ie/en/ckl16/
Human Rights and Mental Health TribunalsDarius Whelan
Irish Association of Social Workers
Learning from each other; Critical Reflections on the intersections between the Mental Health Act 2001 and Human Rights.
Dublin, February 2019
Shari McDaid - The Mental Health Act 2001: Issues from a Coalition PerspectiveDarius Whelan
Dr Shari McDaid - The Mental Health Act 2001: Issues from a Coalition Perspective
Dr Shari McDaid is the Director of Mental Health Reform.
Presented at Mental Health Law Conference 2015 - Centre for Criminal Justice & Human Rights, School of Law, University College Cork and Irish Mental Health Lawyers Association.
25 April 2015
http://www.imhla.ie
#mhlaw2015
Dr Liz Brosnan: Voices from the Margin / Psychiatric Hegemony - Mental Health...Darius Whelan
Dr Liz Brosnan: Voices from the Margin / Psychiatric Hegemony.
Dr Liz Brosnan is a Sociologist and Survivor Activist.
Presented at Mental Health Law Conference 2015 - Centre for Criminal Justice & Human Rights, School of Law, University College Cork and Irish Mental Health Lawyers Association.
25 April 2015
http://www.imhla.ie
#mhlaw2015
Maria Morgan: The Mental Health Act 2001 from a Clinician's PerspectiveDarius Whelan
Dr Maria Morgan, Consultant Psychiatrist
The Mental Health Act 2001 from a Clinician's Perspective
Presented at Mental Health Law Conference 2015 - Centre for Criminal Justice & Human Rights, School of Law, University College Cork and Irish Mental Health Lawyers Association
25 April 2015
http://www.imhla.ie
#mhlaw2015
Anselm Eldergill: The Court of Protection and the Mental Capacity Act: Capaci...Darius Whelan
Judge Anselm Eldergill, Court of Protection
The Court of Protection and the Mental Capacity Act: Capacity to Change?
Presented at Mental Health Law Conference 2015 - Centre for Criminal Justice & Human Rights, School of Law, University College Cork and Irish Mental Health Lawyers Association
25 April 2015
http://www.imhla.ie
#mhlaw2015
Michael Lynn: Capacity and Consent Issues [presented at Mental Health Law Con...Darius Whelan
Capacity and Consent Issues - Mr Michael Lynn, Senior Counsel
Presented at Mental Health Law Conference 2015 - Centre for Criminal Justice & Human Rights, School of Law, University College Cork and Irish Mental Health Lawyers Association
25 April 2015
http://www.imhla.ie
#mhlaw2015
Developing Students' E-Literacy (Teaching and Learning)Darius Whelan
Presentation at University College Cork Digital Day, December 2014
http://www.ucc.ie/en/teachlearn/tel/digitalday2014/
Organised by Vice Presiodent for Teaching and Learning.
Ionad Bairre.
A "File Trademark" is a legal term referring to the registration of a unique symbol, logo, or name used to identify and distinguish products or services. This process provides legal protection, granting exclusive rights to the trademark owner, and helps prevent unauthorized use by competitors.
Visit Now: https://www.tumblr.com/trademark-quick/751620857551634432/ensure-legal-protection-file-your-trademark-with?source=share
Military Commissions details LtCol Thomas Jasper as Detailed Defense CounselThomas (Tom) Jasper
Military Commissions Trial Judiciary, Guantanamo Bay, Cuba. Notice of the Chief Defense Counsel's detailing of LtCol Thomas F. Jasper, Jr. USMC, as Detailed Defense Counsel for Abd Al Hadi Al-Iraqi on 6 August 2014 in the case of United States v. Hadi al Iraqi (10026)
Car Accident Injury Do I Have a Case....Knowyourright
Every year, thousands of Minnesotans are injured in car accidents. These injuries can be severe – even life-changing. Under Minnesota law, you can pursue compensation through a personal injury lawsuit.
Hunger Strikes in Prison: The Legal Issues Oct 2020
1. Hunger Strikes in Prison –
The Legal Issues
Darius Whelan,
School of Law, University College Cork
Terence MacSwiney, Cork Men’s Gaol, and the Political
Hunger Strike, 1920-2020
School of History, UCC, October 2020
3. Different motivations for / causes of food
refusals in prison
• Food Refusal (FR)/ Hunger Strike (HS) as a form of
protest,
• FR/HS as a deliberate act of self-harm,
• FR/HS related to a mental illness (e.g. depression /
psychosis / eating disorders) and/or
• FR/HS as an attempt to ‘frustrate’ a prison sentence.
3
4. Relevant Rights
4
Right to
Health
Right to
Bodily
Integrity
Right to Self-
Determination
Right to
Autonomy
Right to
Life
Right to
Privacy
Freedom from torture /
inhuman or degrading
treatment
6. 6
“Prisoner” or “Patient” ?
Courts have held:
Some rights of prisoners are
abrogated, limited or suspended
or abrogated during their period of
imprisonment.
8. Criminal law concerning suicide
8
Ireland – crime of suicide abolished by Criminal Law (Suicide)
Act, 1993.
Aiding and abetting suicide continues to be a crime.
Suicide is still contrary to public policy (Humphreys J. in A.B. v
C.D. (2016))
In UK – crime of suicide abolished by Suicide Act 1961, but
aiding and abetting a suicide continues to be a crime
9. Relevant Legislation if there are
mental health or capacity issues:
9
• Criminal Law (Insanity) Act 2006
• Prisoners can be transferred to
Central Mental Hospital,
Dundrum
• Mental Health Act 2001
• Provisions in ss.56-60 apply if
detained person does not have
capacity
Photograph by Dara Mac Dónaill from Irish Times
12. Leigh v Gladstone, 1909
12
UK Case
Prison governors had a duty to
preserve the health of prisoners, a duty
which extended to force feeding.
Thus, they were permitted to force-feed
hunger striking suffragettes at a time
when suicide was illegal.
Photograph By LSE Library - https://www.flickr.com/photos/lselibrary/35720938521/ , No
restrictions, https://commons.wikimedia.org/w/index.php?curid=67341188
13. Secretary of State for Home
Department v Robb, 1995
13
• UK Case
• It was lawful for the prison authorities not to intervene if a
prisoner with capacity was on hunger strike.
• It is not suicide to refuse to consent to treatment, which then
leads to one’s death.
• Mr R. had personality disorder but had capacity
14. R. v Collins ex parte Brady, 2000
14
UK Case
If a hunger striking prisoner was also
detained under the Mental Health Act and
lacked capacity, he could be force-fed.
Force feeding could be a medical
treatment within the Mental Health Act
1983
Hunger strike was a manifestation of his
personality disorder.
It was common ground that force feeding
was medical treatment.
15. Nevmerzhitsky v Ukraine, 2006
15
European Court of Human Rights
Mr N. did not have a psychiatric diagnosis.
Force-feeding a prisoner on hunger strike was not
a breach of the Convention, provided there was a
“medical necessity” and the method used was
humane
The Ukrainian government did not respond to the
case.
On the facts – there was not a medical necessity
(it was arbitrary) and the method was inhumane,
so art. 3 had been breached.
16. Governor of X Prison v McD. (2015)
Irish case
Prisoner refusing food; had full capacity.
Prison could lawfully withhold medical and nutritional assistance.
The autonomy to choose medical treatment derives from the right to
life.
The right to life includes a right to die with dignity.
Mr McD. had borderline Personality Disorder but not mental disorder.
Court held that Mr McD’s advance directive (a letter) was important
and ought to be respected by those with care of the person.
16
17. A.B. v C.D. (2016)
• Irish case. Not a hunger striking case.
• Prisoner had self-inflicted injury to neck.
• He was assessed as lacking capacity to refuse treatment.
• Court did not make finding on capacity.
• A prisoner in custody under a court order is not entitled to
refuse treatments where this would either directly or
ultimately put his life at risk and thereby frustrate the court’s
verdict and order.
• Prisoner cannot “cheat justice”.
17
18. • But court did not disagree with outcome in McD. as
executive had discretion – governor had chosen to
withhold assistance.
• In this case – Court granted declaration authorising the
prison to administer all medical and/or surgical treatment
that might be recommended by its medical staff in the
interests of the defendant's medical welfare.
18
20. Brehon Law
20
Troscud
• (referred to by Baker J. in Governor of
X Prison v McD.)
• Fasting, or going without food, for the
purposes of extracting justice or
redressing a wrong has had a long
history in Ireland and indeed it could be
said to be a particularly Irish form of
protest.
• Video on Troscud - (Kevin Flanagan,
Brehon Law Academy) :
https://youtu.be/ONBLOvWMwbU
21. Suffragettes
21
• Mary Leigh – see Leigh v
Gladstone, referred to earlier
Unknown author, Public Domain - https://commons.wikimedia.org/wiki/File:Force-
feeding_(suffragettes).jpeg
22. Grace Roe and Nellie Hall – 1914
• Arthur Barnett, the clerk of Arthur Marshall, the solicitor of the Women’s
Social and Political Union, was observed passing a small packet to
Roe.
• When examined, the packet was found to contain six small tablets. The
tablets caused vomiting.
• Barnett was convicted under the Prisons Act 1865 for his attempts to
smuggle in the drugs.
22
William Murphy - https://histprisonhealth.com/2016/12/08/the-health-of-suffragette-prisoners-force-
feeding-and-vomiting/
23. Prisoners (Temporary Discharge
for Ill Health) Act 1913
23
“The Cat and Mouse Act”
Museum of London Poster -
https://commons.wikimedia.org/wiki/File:Cat_and_Mouse_Act_Poster_-_1914.jpg
24. Events in 1974-1975
24
• Dolours and Marian Price force-fed in English
prison
• Michael Gaughan died while on hunger strike
in the Isle of Wight. He had been force fed a
number of times.
• Roy Jenkins, Home Secretary, announced that
hunger strikers would no longer be force-fed
• 1975: Word Medical Association declared that
hunger strikers with capacity should not be
artificially fed
Photograph from independent.co.uk
25. H Blocks Hunger
Strike 1981
25
• Force feeding was not used
• European Commission on
Human Rights involvement
• Some hunger strikers elected
as MPs
• UK: Representation of the
People Act 1981 – Prisoners
could no longer be nominated
or elected.