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Dominic Wilkinson’s Posts

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?

Cross Post: Should A Health Professional Be Disciplined For Reporting An Illegal Abortion?

Written by: Prof Dominic Wilkinson, University of Oxford

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

Prostock-studio/Shutterstock 
There have been several high-profile cases in the last year of women in the UK being prosecuted for allegedly obtaining abortions illegally. In 2022, there were 29 cases of suspected unlawful abortions that were reported to police – almost a twofold rise on the number reported four years earlier.

In response to this, the Royal College of Obstetrics and Gynaecologists (RCOG) has issued guidance that seeks to clarify the legal obligations of healthcare professionals. The full guideline has not yet been released, but the RCOG insists that professionals “are under no legal obligation to contact the police following an abortion, pregnancy loss or unattended delivery”.Read More »Cross Post: Should A Health Professional Be Disciplined For Reporting An Illegal Abortion?

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

Cross Post: Dutch Government to Expand Euthanasia Law to Include Children Aged One to 12 – An Ethicist’s View

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Written by Dominic Wilkinson, University of Oxford

Ernst Kuipers, the Dutch health minister, recently announced that regulations were being modified to allow doctors to actively end the lives of children aged one to 12 years who were terminally ill and suffering unbearably.

Previously, assisted dying was an option in the Netherlands in rare cases in younger children (under one year) and in some older teenagers who requested voluntary euthanasia. Until now, Belgium was the only country in the world to allow assisted dying in children under 12.

Under the proposal, it will remain against the law for doctors in the Netherlands to actively end the life of a child under the age of 12. However, a force majeure clause gives prosecutors the discretion not to prosecute in exceptional circumstances.

In 2005, Dutch doctors and legal experts published guidelines (the so-called “Groningen protocol”) elaborating when these exceptional circumstances would apply for infants under the age of one year. That included certainty about diagnosis and prognosis, “hopeless and unbearable suffering”, the support of both parents and appropriateness confirmed by an independent doctor.

The new regulations would allow the same principles to apply to children between one and 12 years of age.Read More »Cross Post: Dutch Government to Expand Euthanasia Law to Include Children Aged One to 12 – An Ethicist’s View

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?