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Dominic Wilkinson

Declaration of Helsinki turns 60 – how this foundational document of medical ethics has stood the test of time

The declaration of Helsinki recently turned 60, but don’t feel bad if you missed the celebrations. It probably passed unnoticed by most people not working in the medical field – and possibly even a good few in the field. If you’re not familiar with the declaration – adopted by the World Medical Association on October… Read More »Declaration of Helsinki turns 60 – how this foundational document of medical ethics has stood the test of time

Would You Survive Brain Twinning?

Imagine the following case: A few years in the future, neuroscience has advanced considerably to the point where it is able to artificially support conscious activity that is just like the conscious activity in a human brain. After diagnosis of an untreatable illness, a patient, C, has transferred (uploaded) his consciousness to the artificial substrate… Read More »Would You Survive Brain Twinning?

Quasi-Refusal and Teens

by Dominic Wilkinson In an interesting legal case earlier this year, the court held an emergency hearing about the medical care of a 16 year old, recently diagnosed with acute leukaemia. The hearing, conducted remotely in the middle of the night, was to decide whether she should have medical treatment imposed against her wishes. Should an “intelligent… Read More »Quasi-Refusal and Teens

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?