European journal of health law
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The recent case of David Bradley, who shot and killed four members of his family after telling his doctor he 'wanted to kill someone', has raised the question of whether a healthcare professional could ever be held liable for failing to take steps to constrain a potentially dangerous patient. Until recently, it was considered that the United Kingdom courts would be reluctant to impose a duty to protect third parties. ⋯ When this duty will arise, and how it can be discharged, remain challenging questions. Furthermore, healthcare professionals face the unenviable task of balancing competing duties, in which the rights--and safety--of their patients must also be borne in mind.
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In December 2005 the first national guideline for palliative sedation in the Netherlands was published. This guideline was developed by a committee of the Royal Dutch Medical Association, at the request of the Dutch government. The guideline defines palliative sedation as 'the intentional lowering of consciousness of a patient in the last phase of his or her life'. ⋯ Palliative sedation is given in the last phase of life, in the imminently dying patient. Palliative sedation raises several legal questions. In this article we describe the structure and contents of the guideline, with special attention for the main legal issues involved, like the distinction between palliative sedation and euthanasia and the process of informed consent.
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In this article the author considers whether healthcare professionals should be under a legal duty to persuade their patients to change their minds when they have made an apparently irrational decision.
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Current international legal instruments recognise the use of advance directives to carry on the will of the dementing research participant beyond the boundaries of her present legal capacity. Advance directives are gaining greater recognition in patient care than in medical research, where their legal status is still somewhat unclear. In particular, the three major international documents on medical research - the Council of Europe Convention on Biomedicine and Human Rights (ETS 164), its Additional Protocol on Biomedical Research (ETS 195), and Directive 2001/20/EC on Clinical Trials on Medicinal Products--give conflicting messages on the legal status of advance directives in medical research. This article examines the provisions in these documents and their national applications in Finland and the United Kingdom.