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Dominic Wilkinson

Why a US State Court Ruling on the Rights of Children Before Birth is Unjust

Dominic Wilkinson, University of Oxford. In 2020, in a medical facility in one of the southern states of the US, a patient wandered into an unsecured nursery for extremely premature children. Unfortunately, the patient managed to accidentally disconnect multiple babies from their life support. Worried that they would get in trouble, they fled the scene.… Read More »Why a US State Court Ruling on the Rights of Children Before Birth is Unjust

Cross Post: What’s wrong with lying to a chatbot?

Written by Dominic Wilkinson, Consultant Neonatologist and Professor of Ethics, University of Oxford

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Imagine that you are on the waiting list for a non-urgent operation. You were seen in the clinic some months ago, but still don’t have a date for the procedure. It is extremely frustrating, but it seems that you will just have to wait.

However, the hospital surgical team has just got in contact via a chatbot. The chatbot asks some screening questions about whether your symptoms have worsened since you were last seen, and whether they are stopping you from sleeping, working, or doing your everyday activities.

Your symptoms are much the same, but part of you wonders if you should answer yes. After all, perhaps that will get you bumped up the list, or at least able to speak to someone. And anyway, it’s not as if this is a real person.Read More »Cross Post: What’s wrong with lying to a chatbot?

Horror, Fear and Trust in a Neonatal Unit

by Dominic Wilkinson

This week, closing evidence was presented in the long-running trial of Lucy Letby, a nurse who is accused of murdering seven newborn infants (and attempting to murder 10 more) in a neonatal intensive care unit in Chester between 2015 and 2016. In the coming weeks, the jury will consider and then return their verdict on the charges. That verdict will bring some closure to a criminal investigation that has taken more than four years, and a trial that has lasted nine months. It may (though may not) provide some relief for the grieving families whose babies died seven or eight years ago.
Yet, whatever verdict is reached, there are likely to be profound wider repercussions for all those who work in the care of very sick infants and children, and for many many other parents and families.Read More »Horror, Fear and Trust in a Neonatal Unit

Press release: Battersbee appeal at European Court declined

by Dominic Wilkinson @Neonatalethics Tonight, the European Court responded to Archie’s parents’ request for a final appeal against the decision by a series of UK courts to end the treatment keeping him alive.   What happened in the European Court?   The European Court provided a rapid answer to the application by Archie’s lawyers earlier… Read More »Press release: Battersbee appeal at European Court declined

Press release: Battersbee final* appeal rejected

by Dominic Wilkinson In the latest legal hearing, in a long running dispute about treatment for brain-injured 12 year old Archie Battersbee, the Court of Appeal yesterday rejected his family’s request to delay stopping treatment until a UN committee had reviewed his case. Why was the appeal rejected? Archie’s parents had previously mounted a series… Read More »Press release: Battersbee final* appeal rejected

Press Release: Court of Appeal decision in Dance & Battersbee (respondents/appellants) v Barts Health NHS Trust

by Dominic Wilkinson

Archie is legally alive, and the legal decision about whether it is in his best interests to keep him alive now needs to be revisited in the High Court.

Today, the Court of Appeal made a decision in the case of Archie Battersbee to send the case back to the High Court to examine what should happen next in his medical treatment.

Two questions

There are two separate questions. First, is Archie legally dead. Second, should life support machines continue?

Read More »Press Release: Court of Appeal decision in Dance & Battersbee (respondents/appellants) v Barts Health NHS Trust

Should Parents be Able to Decline Consent for Brain Death Testing in a Child?

by Dominic Wilkinson

In the recently reported case of Archie Battersbee, a 12 year old boy with severe brain damage from lack of oxygen, a judge declared that he had died on 31st May. This was almost eight weeks after his tragic accident, and five weeks after doctors at his hospital first applied to the court for permission to test him. His parents have appealed the ruling, and the appeal hearing is likely to be heard in the Court of Appeal next week.

If the judgement is correct that Archie is, sadly, legally dead, it is extremely likely that this has been the case for more than a month and potentially now more than two months. One of his doctors testified that in the view of the specialists looking after him it was likely that Archie’s brain stem had died between 8th and 26th April. While it would not be unusual for doctors and families to take a few days to discuss and then proceed with formal testing, this length of delay is extremely unusual in the UK. The delay in making a definite determination in Archie’s case is because his parents declined consent for brain death testing.

But that might lead us to ask: should parents be asked for consent to testing in these cases?Read More »Should Parents be Able to Decline Consent for Brain Death Testing in a Child?

Archie Battersbee: How the Court Reached its Conclusion

Mother of Archie Battersbee, Hollie Dance, outside the high court in London, England.
PA Images / Alamy Stock Photo

Dominic Wilkinson, University of Oxford

London’s high court has heard the tragic case of 12-year-old Archie Battersbee, who suffered severe brain damage after an accident at his home in Southend, Essex, in early April.

On Monday, Mrs Justice Arbuthnot concluded that Archie was brain dead and that treatment should cease. His parents disagree and are planning an appeal.

There have been other cases where parents or family members have not accepted a medical diagnosis of brain death. In the UK, courts have always concluded that treatment should stop. However, one difference in Archie’s case is that the standard tests for brain death were not possible. The judge relied in part on a test (an MRI brain scan) that is not usually used.Read More »Archie Battersbee: How the Court Reached its Conclusion

NHS and Care Home Mandates Should Take Account of Natural Immunity to COVID

by Dominic Wilkinson, Jonathan Pugh, Julian Savulescu

 

Yesterday, the health secretary, Sajid Javid announced that COVID vaccines would become mandatory for frontline NHS staff from April.

Meanwhile, from tomorrow care home workers in the UK will not be able to work if they don’t have a vaccine certificate and are not medically exempt. This vaccine mandate has been controversial, with providers raising concerns that as many 70’000 employees could leave the sector putting beds and care at risk. However, its advocates have argued that it is a proportionate public health measure due to the need to protect vulnerable care home residents.

Proportionality is one key ethical criterion in public health ethics; public health interventions are only permissible if their benefits outweigh their costs. However, another key ethical criterion is necessity; public health interventions are only permissible if they are necessary for achieving a certain benefit.

One striking feature of the current UK care home and NHS staff mandate is that it does not allow an exemption for those who have proof of natural immunity.

Read More »NHS and Care Home Mandates Should Take Account of Natural Immunity to COVID

COVID: Media Must Rise Above Pitting Scientists Against Each other – Dealing With the Pandemic Requires Nuance

Krakenimages/Shutterstock

Trish Greenhalgh, University of Oxford and Dominic Wilkinson, University of Oxford

At the start of the pandemic, there was a striking sense of shared resolve and solidarity. Facing a public health crisis greater than any in living memory, people were largely united in their support of difficult measures to protect the vulnerable, safeguard the health system and sustain key workers.

There were, of course, differences of opinion. For example, some disagreed about the severity of the threat posed by COVID, about the wisdom of different national approaches to lockdown, about the timing of restrictions, and the effectiveness face masks.

More recently, there has also been disagreement on how vaccines should be distributed, whether vaccine passports are a good idea, and whether vaccination should be mandatory for certain occupations)

Throughout the pandemic, scientists attempting to explain their findings have had to deal with unprecedented levels of dissent, anger and abuse from the lay public and occasionally from other scientists.

Since the government lifted COVID restrictions on July 19, views on how best to handle the pandemic have become more polarised than ever, broadly splitting into two camps: the “open up” camp and the “not yet” camp.Read More »COVID: Media Must Rise Above Pitting Scientists Against Each other – Dealing With the Pandemic Requires Nuance