Law, Ethics and Lockdowns: Impacts on Life, Liberty and the Economy.

Many people worldwide, particularly those with disabilities and the elderly, suffered greatly not only as a result of the Covid-19 pandemic but also as a result of the lockdowns. In this article we set out widely-accepted ethical criteria for assessing when coercive public health measures are justified. We then review the empirical evidence, not least concerning the benefits and costs of the lockdowns, and conclude that lockdowns as instituted in the UK (and, presumptively, in many other jurisdictions) appeared to breach those criteria. We conclude that any future proposal to lockdown should be subjected to the strictest ethical scrutiny, and that a lockdown should not be contemplated unless it could be convincingly demonstrated that the benefits would substantially outweigh the harms; that it would be proportionate, and that legal coercion would be strictly necessary.

Prolonged disorders of consciousness: a critical evaluation of the new UK guidelines.

In March 2020, the Royal College of Physicians in the UK published national guidelines on the management of patients with prolonged disorders of consciousness, updating their 2013 guidance 'particularly in relation to recent developments in assessment and management and … changes in the law governing … the withdrawal of clinically assisted nutrition and hydration'. The report's primary focus is on patients who could live for many years with treatment and care. This update, by a neurologist, an imaging neuroscientist, and a lawyer-ethicist, questions the document's rejection of any significant role for neuroimaging techniques including functional MRI and/or bedside EEG to detect covert consciousness in such patients. We find the reasons for this rejection unconvincing, given (i) the significant advances made in the use of this technology in recent years; and (ii) the wider scope for its use envisaged by the earlier (2018) guidelines issued by the American Academy of Neurology. We suggest that, since around one in five patients diagnosed with prolonged disorders of consciousness are in fact conscious enough to follow commands in a neuroimaging context (i.e. those who are 'covertly conscious' or those with 'cognitive motor dissociation'), and given the clinical, ethical and legal importance of determining whether patients with prolonged disorders of consciousness are legally competent or at least able to express their views and feelings, the guidance from the Royal College of Physicians requires urgent review.

"Voluntary assisted dying" in Australia: the Victorian parliamentary committee's tenuous case for legalization.

In 2016 a Parliamentary Committee in Victoria, Australia, recommended the legalization of physician-assisted suicide and voluntary euthanasia. Its report was deeply flawed. Its treatment of key objections to legalization, both principled and practical, was superficial and selective. The Voluntary Assisted Dying Act, passed by the Victorian Parliament in November 2017, is built on the report's shaky foundations.

Back to the future of abortion law: Roe's rejection of America's history and traditions.

In Roe v. Wade much of Justice Blackmun's judgment was devoted to the history of abortion in Anglo-American law. He concluded that a constitutional right to abortion was consistent with that history. In Webster v. Reproductive Health Services, 281 American historians signed an amicus brief which claimed that Roe was consistent with the nation's history and traditions. This article respectfully questions Justice Blackmun's conclusion and the historians' claim.

Medical murder by omission? The law and ethics of withholding and withdrawing treatment and tube feeding.

When is it lawful and ethical to withhold or withdraw treatment and tube feeding? In recent years, the courts have handed down important decisions and medical bodies have issued professional guidelines on withholding and withdrawing treatment and tube feeding. A major criticism of these decisions and guidelines has been that while they prohibit the intentional hastening of a patient's life by an act ('active euthanasia'), they permit the intentional hastening of a patient's death by omission ('passive euthanasia'); and they prohibit actively assisting suicide, but permit passively assisting suicide. By focusing on the landmark decision of the Law Lords in the Tony Bland case, and on the guidelines on withholding and withdrawing treatment and tube feeding issued by the British Medical Association, this paper considers whether this criticism is sound, and concludes that it is.

A reply to McLachlan.

In an earlier article in this journal, I advanced five ethical arguments in favour of a voluntary, unpaid system of blood donation. In his reply to my article, Hugh McLachlan criticised one of those arguments, namely, the argument that an unpaid system promotes altruism and social solidarity. In this reply to Dr. McLachlan, I maintain that his criticism is misguided, and that he appears unclear not only about my own argument, but also about his own.