Mason & McCall Smith's Law and Medical Ethics

Citation

Farrell, A.-M., & Dove, E. S. (2023). Mason & McCall Smith's Law and Medical Ethics (12th ed.). Oxford University Press.

Chapter Summary

The twelfth edition has eighteen chapters and, in a reviewer's count, 702 pages. The publisher says the table of contents was reorganised and streamlined for this edition, with two new chapters on concepts, theories and tools for analysing health and medical law and a new chapter on UK health systems. The sequence runs from ethical frameworks, through the structure of health care and its professions, to treatment decisions and then to questions of reproduction and the end of life.

Chapters 1–2: Introduction to bioethics; Critical frameworks in bioethics

The two chapters that the publisher describes as new for this edition introduce the concepts, theories and tools that frame interpretation and analysis of health and medical law. A reviewer describes the book as guiding the reader first through the core tenets of medical ethics and then through the legal topics.

Chapter 3: Governance of the health system

The publisher presents this as a new overview of UK health systems, set in the context of devolution, the Covid-19 pandemic and Brexit. A reviewer finds it useful as a guide to health system governance across the whole United Kingdom rather than England and Wales with Scotland and Northern Ireland added.

Chapters 4–5: Health and social care professionals; Health resource allocation

Chapter 4 concerns the professions that provide health and social care; Chapter 5 concerns how limited health resources are allocated.

Chapters 6–7: Health research and innovation; Public health

Two chapters on the wider setting of health: research and innovation, and public health.

Chapters 8–9: Consent to medical treatment; Children and consent to medical treatment

The treatment-decision chapters begin with consent in general and then consent for children.

Chapter 10: Mental health

A chapter on mental health law.

Chapters 11–12: Medical confidentiality and data protection; Clinical negligence

Chapter 11 pairs medical confidentiality with data protection; Chapter 12 covers clinical negligence.

Chapters 13–14: Organ donation for transplantation; The body as property

Two chapters on the body: organ donation for transplantation, where the publisher notes new regimes, and the body as property.

Chapters 15–16: Contraception and pregnancy; Assisted conception

The reproduction chapters cover contraception and pregnancy, then assisted conception.

Chapters 17–18: Withdrawal and withholding of medical treatment; Euthanasia and assisted suicide

The last two chapters deal with the end of life: withdrawing and withholding treatment, and euthanasia and assisted suicide. A reviewer singles out the book's analysis of how life-sustaining treatment decisions for people who cannot decide for themselves differ between Scotland and England and Wales.

Key Concepts

Frameworks and the health system (Chapters 1–7)

• Bioethics and critical frameworks: the concepts, theories and tools introduced in Chapters 1 and 2.
• Governance of the health system: the structure of health care across the United Kingdom after devolution.
• Resource allocation: the subject of Chapter 5.
• Public health and research: Chapters 6 and 7.

Treatment and the body (Chapters 8–14)

• Consent: for adults and, separately, for children.
• Confidentiality and data protection: Chapter 11.
• Clinical negligence: Chapter 12.
• The body as property: Chapter 14, alongside organ donation.

Reproduction and the end of life (Chapters 15–18)

• Assisted conception: Chapter 16.
• Withdrawal and withholding of treatment: Chapter 17.
• Euthanasia and assisted suicide: Chapter 18.

Critical Analysis

Strengths

• A UK-wide perspective. A reviewer in the Mental Capacity Law and Policy blog (October 2023) stresses that the book is written from a Scottish perspective and does not assume that Scots and English law are the same. The publisher's description likewise states that it covers Scots law as well as English law. That is unusual among medical law textbooks.
• Ethics and law together. The book opens with ethics chapters and the publisher says it sets out a diversity of views in ethical debates and offers the authors' own perspectives. The reviewer adds that the authors flag contrary positions, so the effect is stimulating rather than preaching.
• Wide coverage. Eighteen chapters run from health system governance to assisted dying, which the reviewer describes as covering almost every area a reader in the United Kingdom could want.
• Recent developments. The publisher lists the Health and Social Care Act 2022, the Mental Health Bill 2022, the Medicines and Medical Devices Act 2021, the Coronavirus Act 2020, new regimes for organ donation and recent cases including Bell v Tavistock, ABC v St George's Healthcare NHS Trust and Khan v Meadows among the material covered.

Limitations

• Long and continuous. At about 700 pages of narrative, it is more than a single course needs. It is a textbook rather than a casebook of extracts, so a reader who wants judgments in full has to use the law reports.
• A stated viewpoint. The authors express their own views on whether judgments and policy are right. This is useful for debate but means readers should keep their own judgment active.
• Minor presentation points raised by the reviewer. The reviewer notes that English judges are sometimes referred to as "Justice [name]", which jars for an English lawyer, and that the paperback printing was uneven.

Where It Fits in the Course

Among the medical law books on the list, this is a full-length treatise-style textbook. Medicine, Patients and the Law is a survey of medical law in England and Wales for students and general readers, and the Mental Capacity Law and Policy reviewer recommends owning both: that book offers more historical grounding in how the law reached its present position in each place, this one more of the ethical tools for asking whether the positions are right. Pattinson's Medical Law and Ethics is a single-author textbook for England and Wales that combines legal analysis with moral theory, and the other Medical Law and Ethics on the list presents the law of England and Wales with the ethical arguments around it. Medical Law: Text, Cases, and Materials is a graduate-level casebook organised around extracts. Medical Law: A Very Short Introduction is the short entry point to read first if the subject is new.

How to Use This Book

The book suits law students taking medical law, postgraduate students in health law or bioethics, and students from medicine and health care who want a careful legal and ethical account. It is particularly suited to anyone studying in Scotland or working across the United Kingdom.

A practical plan:

• Core: Chapters 1–3 for the frameworks and the health system, then Chapters 8, 11 and 12 on consent, confidentiality and negligence, which most courses treat first.
• By syllabus: Chapters 9–10 (children and mental health), 15–16 (reproduction) and 17–18 (end of life), according to what the course covers.
• Optional or specialised: Chapters 4–7 and 13–14 on professions, resources, research, public health, organ donation and the body as property.

Read the ethical argument and the legal rule together for each topic, and compare the Scottish position with the English one where the chapter distinguishes them. The edition cites the Mental Health Bill 2022 as a bill, so check later legislative developments for mental health law.