NORTHUMBRIA UNIVERSITY

SCHOOL OF LAW
LLB (HONS) OPEN LEARNING
MEDICAL LAW
LA0897

ZONE 2

May 2018 Time allowed: 3 hours

Instructions: PART A: YOU MUST ANSWER QUESTION 1.

PART B: YOU MUST ANSWER TWO QUESTIONS FROM

THIS PART

NO MATERIALS ALLOWED IN THE EXAMINATION

PART A

.
1. Rex, aged 39, was involved in a cycling accident in 2017. At the Oldcastle
NHS Trust Hospital he was treated for two broken bones in his arm, a broken
nose and facial cuts and bruises. He complained to the Accident and
Emergency doctor, Dr Lisp, a junior doctor, of a pain in his chest but on a
quick examination and without an x-ray being taken, he was told he only had
three bruised ribs. He returned to the hospital a further three times for his
injuries to be treated and on each occasion he mentioned the chest pain but
nothing was done.

Subsequently he developed a very bad cough which resulted in him

collapsing one day at work. His General Practitioner (GP), Dr Stick, diagnosed
a pulled muscle brought on by the coughing and signed Rex off work for a
 week. Rex continued to suffer chest pain and he made another appointment
with Dr Stick. At Rex’s insistence Dr Stick eventually agreed to an x-ray being
taken of his chest. For three months he heard nothing from Dr Stick or the
Oldcastle NHS Trust Hospital about the x-ray results and he continued to
suffer intermittent pain. Eventually he went back to his GP practice and saw a
different GP, Dr Tall. When Dr Tall consulted Rex’s notes he confessed that
the letter from the Oldcastle NHS Trust Hospital about the x-ray had been
filed, in fact it confirmed two months ago that Rex had a collapsed lung. Soon
afterwards Rex underwent emergency surgery but his condition has steadily
deteriorated.

Medical evidence has since shown that if his condition had been diagnosed
earlier Rex would have had a 60% chance of making a full recovery.

Discuss the possible prospects of success of establishing a breach of the duty

of care and causation against of any of the aforesaid parties.

NOTE TO STUDENTS: YOU ARE ASKED TO DISCUSS LIABILTY ONLY;

YOU NEED NOT DISCUSS QUANTUM IN YOUR ANSWER.

50 marks

2. Discuss the legal and ethical issues arising in the following alternative
scenarios:

(a) Tess, unfortunately came into contact with rubella in the early stages of
pregnancy. At the hospital she asked whether it is likely that her foetus has
been infected with rubella. Tests confirm this to be so but due to an error in
communications on the part of the hospital, she was not informed. She gives
birth to a baby who is both deaf and blind. Tess feels that her child is so badly
disabled that she would have had a termination to end the pregnancy if she
 has been made aware that her child was infected with rubella. She wishes to
know whether she can claim for all of the costs of the child’s upbringing.

7 marks

(b) Viola and Cuthbert have three children and decided that their family was now
complete. Cuthbert proceeded to have a vasectomy operation and was told
by the surgeon that he was now sterile and could resume sexual relations
with Viola. Two months later Viola discovers she is pregnant and
subsequently gives birth to a healthy son. Cuthbert has since learned that his
surgeon should have advised him to use other contraceptive precautions
following his vasectomy for a six month period as there was a possibility of a
natural reversal of the operation.
Cuthbert and Viola love their new son but want to bring a damages claim for
the costs of his upbringing. These are likely to be extensive as Viola needs
additional help to care for her children as she is disabled.

7 marks

(c) Kim, aged 40, decided that she would like to start a family but did not want to
take any time off work. Bess, in consideration of a payment of £25,000,
agreed to carry a child for Kim and her husband, Nick, following Bess’s
artificial insemination with Nick’s sperm. Following the birth of the child Bess
initially hands the child over to Kim who pays her an extra £15,000 as a token
of her gratitude. However, after eight weeks Bess says she cannot go
through with the agreement and wants the child back. Kim refuses as she
says she is now the legal mother. Kim’s husband Nick however is keen for
the child to be returned to Bess. Bess intends to bring the child up as her own
with the help of her partner, Gillian.

11 marks
3. The UK law on abortion has little regard for a woman’s wishes. In truth it is
little more than a mechanism for doctors to justify their treatment decisions.

Critically discuss the issues that arise in relation to the above statement.

25 marks

4. During the course of an evening shift at the Accident and Emergency

Department at Oldcastle Hospital the following issues events occur:

A man is assessed by the triage nurse. He tells the nurse his name is ‘Archie’
but he will not provide any further details. He has deep lacerations to his
arms and a broken nose. He insists he has sustained these injuries falling
down the stairs. Police arrive at reception and ask if a patient has been
admitted with knife wounds as there has been a ‘gang’ fight nearby resulting
in a girl’s death.

A teenage girl also attends the department. She informs staff she thinks she
is having a miscarriage. She refuses to give her name unless they promise
not to tell her Mum. She eventually provides her name (Carla) and address.
She also tells a nurse she is 14 years old. While lifting the girl’s sleeve to take
her blood pressure, the nurse sees the girl has recent wounds to her arms
which may be evidence of self-harm.

An elderly lady arrives in an ambulance in a dazed and confused state having

been found wandering through the local park in her nightie and slippers. She
is able to tell staff the name of her care home and that her name is Dot. In the
meantime, her son attends reception demanding to know if his mother has
been admitted to the hospital as when he went to the care home to visit her
he was told she has gone missing. Dot demonstrates a great deal of distress
when she is asked whether she would like her son to know she is in hospital.
 Discuss the medical confidentiality issues which arise.

25 marks

5. By refusing to allow active voluntary euthanasia the law first ignores the right
of self-determination and secondly fails to explain why the principle of sanctity
of life is given lesser weight in refusal of medical treatment scenarios.

Critically discuss the above statement.

25 marks

6. (a) Connie is 27 years old and has a severe learning disability and lacks the
capacity to make most day to day decisions. It is suspected that she is
suffering from toothache and she requires dental treatment. She has not had
any dental treatment or check- ups for a long period of time since she is so
resistant to going to the dentist, refuses to allow the dentist to look in her
mouth at all, and on his last visit she hit out at the dentist and had to be
restrained. After consideration by the health professionals looking after
Connie it is decided that the only way it would be safe to proceed with the
check-up and any necessary treatment Connie might need would be for her to
be sedated using a general anaesthetic. Since a dental check-up would not
normally require an anaesthetic and since such an anaesthetic carries an
inherent risk for any patient, the healthcare team want to know whether it
would be lawful for the check-up and any necessary treatment to be carried
out this way.

Advise the healthcare team as to the legal position

12 marks
(b) Esther, aged 15, is rushed to the Accident & Emergency Department of
the local hospital with serious injuries following a cycling accident. She
requires surgery and may need a blood transfusion. She informs the doctors
that she is a Jehovah’s Witness and opposed to blood transfusions on the
grounds of her religion.

Advise the doctors treating Esther as to whether a blood transfusion may be

carried lawfully carried out.
5 marks

c) Frank, aged 50 has been receiving ongoing treatment for incurable lung
cancer. He is admitted to hospital as his condition has deteriorated and he is
drifting in and out of consciousness. The doctors want to treat Frank with a
newly licensed drug which has been proven to slow down the progression of
Frank’s cancer and extend life expectancy by some eighteen months. Frank’s
wife Barbara objects to Frank receiving any further treatment and produces a
document in which Frank has indicated that he does not want any medical
treatment in any circumstances where he has been diagnosed with a terminal
illness. This document is dated ten years previously and witnessed by
Barbara and Frank’s son Leo, then aged 16.

8 marks