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Transforming wrong(s) into right(s): The power of ‘proper medical treatment’

wellcomemanchester uni

This project is a joint collaboration between Sara and Dr Alexandra Mullock (School of Law, University of Manchester) and began with a one day seminar in September 2013, funded by the Wellcome Trust.  The seminar has resulted in a special issue of the Medical Law Review on ‘Conscience and Proper Medical Treatment’, to be published in 2015 and edited by Sara and Alex, and Drs Sheelagh McGuinness and Stephen Smith (School of Law, University of Birmingham).  An edited collection resulting from the September seminar is also planned, and Sara and Alex are working with Professor Penney Lewis (King’s College, London) on a grant application to the Wellcome Trust for a five year project exploring the nature, extent, power, and role of ‘proper medical treatment’ within health care decision-making, from historical, legal, ethical and sociological perspectives.

 

Exploitation in the doctor-patient relationship

This project (with Prof Hazel Biggs (School of Law, University of Southampton)) explores the concept of exploitation in this particular context of the doctor-patient relationship. Thus far, this had led to a book chapter on whether the criminal law should be utilised to criminalise consensual sexual activity in the doctor-patient relationship, published in 2012. A further paper is in the process of being worked on before the final major output: a co-authored book.

 

Reproductive donation: The donation and transfer of human reproductive materials

The Donation and Transfer of Human Reproductive Materials is a five-year programme of research led jointly by Rosamund Scott (Professor of Medical Law and Ethics at King’s College, London) and Stephen Wilkinson (Professor of Bioethics at Lancaster University). It is funded by a Wellcome Trust Senior Investigator Award in Ethics and Society and will run from 2013 until 2017.
The research will consider the ethical framework for the donation and transfer of human reproductive materials (such as eggs and sperm), coupled with the implications of this framework for clinical practice, law, policy, and regulation.
The grant will support a number of post-doctoral researchers, at King’s and at Lancaster, as well research time for the award-holders, and a series of conferences and workshops.
If you have any questions about our research, do please contact us at reproductivedonation@lancaster.ac.uk.

 

 

I.Family: Determinants of eating behaviour in European children, adolescents and their parents

ifamilyGarrath Williams is the Principal Investigator at Lancaster for a large-scale EU project called I.Family (FP7, 2012-17), which is investigating the determinants of health outcomes in a large cohort of European teenagers and their families. Lancaster is responsible for ethical aspects and implications for policy-makers and other stakeholders. The I.Family project follows an earlier study called IDEFICS (FP6, 2006-12) which studied the effect of a community-level intervention on a cohort of 16,000 children in eight European countries. It is the same large group of children which I.Family is now following into adolescence, with the aim of better understanding how dietary choices are made and can be improved.

 

Aspects of medical self-discharge

In February 2012, Lancaster University agreed to fund Dr Laura Machin to research aspects of medical self-discharge. Exploring how people make sense and understand medical self-discharge is important, especially given the number of people who discharge themselves each year in the UK. Medical self-discharge can incorporate a range of activities, from patients discharging themselves from hospital despite healthcare professional advising against this, to people checked-in at A&E departments and leaving without being seen by a healthcare professional. The reasons given for self-discharge include long waiting time, poor bedside manner, and failure of communication amongst hospital staff. As a result, self-discharge has been framed in negative terms particularly as these patients have higher readmission and in-hospital mortality rates. Yet, self-discharge could be perceived as an expression of patients' rights when entering into the 'hidden contract' between health professionals and patients i.e. do as I say if you wish to get better. If patients are perceived as duty-bound to follow medical advice, self-discharge could offer a way of 'equalling' the balance of power between the two. In order to explore this topic, Laura is conducting qualitative interviews with key stakeholders in self-discharge i.e. self-dischargers, healthcare professionals, and hospital management. 

Further information

 

Connections of Workplace Cultures, Patient Safety, and Dignity’

In February 2014, Dr Laura Machin and Dr Dawn Goodwin received funding from the ESRC to explore how the concepts of dignity and patient safety within a healthcare context have become interwoven. A once accepted and unchallenged notion, dignity has sharply resurfaced on the policy, practice and educational agenda as a result of the Francis report. The report documented the failings in healthcare at the Mid Staffordshire Trust that contributed to the death of so many patients. A culture of staff disregard for patients' dignity was explicitly aligned with threats to patient safety in the report. Significantly, this report builds on a growing, but as yet implicit, sense in which 'patient safety' (when conceptualised as avoidance of error) is deemed insufficient as a framework for good care. This movement prompts questions around how the notions of dignity and patient safety have come to coalesce over time and what the practice implications arising from their association might be.   

This phase will analyse professional health care literatures, policy documents and media reports to identify how the concepts of dignity and patient safety have come to coalesce in recent times. The aim of this Work Package is to identify how the concepts of patient safety and dignity, traditionally found in separate discourses, have become interwoven. To do this, we will explore the current literature and work backwards through time until we can no longer find any significant association between the two concepts. Once we have identified our time frame, we will then analyse the shifts in discourse through which the association between patient safety and dignity is made and strengthened, and explore the circumstances that have engendered it. A timeline, charting the historical discursive entanglements of dignity and patient safety, will elucidate how current understandings of dignity and patient safety have taken shape as well as providing insight into a ‘stakeholders map’ by highlighting the parties involved in these constructions.

Further information

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