Published in the Times on 26 July 2013:
Sir
Many arguments have been raised by your recent correspondents concerning Alan Turing, but the nub of the case can be stated simply. Turing was not wrongly convicted because he was a genius; he was wrongly convicted because his actions should never have been a crime in the first place. His conviction would have been equally unjust had he been a drunken layabout instead of a national hero.
There is no need for a retrospective pardon, because Parliament has already made clear that Turing and others should not have been convicted, by repealing the relevant offence, and by the passage of various equality laws in recent years.
Law Journal articles, Legal blogs, information on my books, letters to the Times and a few other things
Monday, 29 July 2013
Friday, 26 July 2013
The last Englishman: Colonel A D Wintle MC
I have been published in the New Law Journal (vol 163, 26 July 2013, p 22) this week, concerning the legendary Colonel Wintle. The article can be found here.
Labels:
law,
Law Stories,
military history,
New Law Journal
Sunday, 7 July 2013
An ugly affair
I have been published in this week's New Law Journal here (££) on the libel case involving Stephen Berkoff and Julie Burchill.
Friday, 28 June 2013
CM v The Executor of the Estate of EJ (deceased) [2013] EWHC 1680 (Fam): a Right to Know
Modern
medical ethics have their origin in the very roots of Western
Civilisation. There is the Hippocratic
oath, deriving from the late fifth century BC, part of which is usually
translated along the following lines:
I will apply dietetic
measures for the benefit of the sick according to my ability and judgment; I
will keep them from harm and injustice.
Then
there is the Biblical Parable of the Good Samaritan (Luke 10:29-37), in which
Jesus tells the story of the beaten and injured traveller (who might be Jewish)
by the side of the road, whom the eponymous Samaritan goes out of his way to
assist despite an historic conflict between Jews and Samaritans. The resultant concept of “neighbour” as one’s
fellow man has been heavily influential not only in medical ethics but also in
law, most famously in Lord Atkin’s speech in Donoghue v Stevenson.
Fully
imbued with modern ethics and the spirit of both Hippocrates and Luke was the
claimant in CM v EJ [2013] EWHC 1680 (Fam) an interesting case raising some fundamental principles of medical law
and philosophy.
The
claimant, referred to as “CM” in the judgment, was a medical doctor, a
consultant and professor at one of London’s principal teaching hospitals. In May 2013, she was driving home, off duty,
when she saw the body of the deceased, EJ, lying motionless on the pavement. EJ
was seriously injured and had bled profusely. CM performed emergency first aid
on EJ but the latter died at the scene. In the course of the resuscitative
efforts, CM's hands became covered with EJ's blood.
On
her return home, CM noticed that she had a number of abrasions on her hands,
probably caused by the alcohol handwash which she used in her work. She was
anxious about the risk of being infected with a blood-borne disease and
commenced a course of prophylactic antiretroviral medication. The drugs, which
had the potential to cause long-term harm, left CM feeling extremely unwell.
CM
wished to establish whether there was any risk that she had been contaminated
by any serious blood- borne illness. The coroner was asked for his co-operation
in obtaining samples of EJ's blood or tissue for testing. He had no objection,
but the problem was that he had no free-standing power to permit the sampling
or testing. It had to come either from
the deceased’s immediate living relatives, or from an order of the High
Court.
The
police were able to trace a family member, OP, who was EJ's mother's cousin. He
confirmed that EJ's parents lived abroad and were not yet aware of her death.
OP stated that he was EJ's closest relative in the United Kingdom and gave his consent
to the taking of a blood sample. To be
on the safe side, CM issued proceedings seeking declarations in the High Court
regarding the lawfulness of the sampling and testing.
The
governing legislation was the Human Tissue Act 2004. It created a range of
offences for removing, storing or using human tissue for purposes without
appropriate consent. Under the 2004 Act,
the Human Tissue Authority (“HTA”) was established to regulate activities
concerning the removal, storage, use and disposal of human tissue; the HTA had
in turn published helpful Codes of Good Practice which were relevant to CM’s
application.
The
judge in the High Court, Cobb J, held that “consent” was the fundamental
principle of the Act and the associated Codes. Consent underpinned the lawful
removal, storage and use of body parts, organs and tissue. In particular, the
Act provided that consent was required for material (such as blood or human
tissue) to be removed, stored or used for “obtaining scientific or medical
information, which may be relevant to a person including a future person.” In
the absence of the requisite consent, the removal, testing, or storing of human
tissue would be a criminal offence (s 5).
The
effect was that:
(i) A coroner
could remove, store and use relevant material for the purpose of the post
mortem examination to determine the cause of death without obtaining the
consent of relatives;
(ii) A coroner did
not have the power to consent to samples being taken for the benefit of a third
party;
(iii) A coroner’s
consent was required before any sample could be removed, stored or used for
purposes other than in the exercise of his own functions or authority.
In
the circumstances, Cobb J held that it was 'not reasonably practicable' to seek
the consents of EJ's parents for the removal or use of blood or tissue from EJ
'within the time available' (s 27(8)). There was no indication that EJ had
other relatives in the list of 'qualifying' persons available from whom consent
could be taken. Further, OP was a person in a 'qualifying relationship' within
the definition of s 3(6)(c) and s 27(4)(h), for the purposes of giving consent
to the removal, storage and use of samples of EJ's blood or human tissue. He
had given relevant consent for the purposes of the Act. Furthermore, the
coroner had indicated his agreement to the removal and testing of the relevant
material, subject to the consent obtained from the qualifying person.
Accordingly, that opened the gateway for the exercise of the court's discretion
under the inherent jurisdiction to authorise the removal, storage and use of
EJ's human tissue samples as sought by CM.
The
jurisdictional hurdle crossed, the court had little hesitation in granting the
relief sought. CM's request only arose because she had undertaken an act of
great humanity in attempting to save EJ's life. If testing were not to be
undertaken, CM would live for the foreseeable future in a state of profoundly
anxious uncertainty as to whether she had contracted a serious,
life-threatening illness. That would doubtless affect not only her personal
well-being, but also her ability to treat other patients in the context of her
highly skilled profession. Further, CM was suffering the harmful (and extremely
discomforting) side-effects of the antiretroviral medication.
CM’s
application was therefore allowed and the tests undertaken. A most happy ending ensued, because the test
results came back negative and CM was able to stop taking the distinctly
unpleasant antiretroviral drugs.
The
result seems obvious in logic: no-one could argue that CM should be told if her
act of spontaneous humanity had had tragic consequences. The need for an answer was all the more
pressing in order to lift the sword of Damocles from above her head in the form
of the uncertainty about disease, and of course to allow CM to stop taking the
excruciating drugs.
Nor
is the case based on unusual or improbable facts – off duty doctors treating
the ill are hardly unknown.
Two
interesting points of wider scope remain.
The first is the extent to which a family’s right to the body of a
deceased – based on culture, religion, or anything else – should be balanced
against either the right of an individual such as CM or indeed society in
general. Suppose the family had been
contactable and refused consent. Suppose
CM suffered irreparable liver or kidney damage as a result of the drugs she was
taking, which turned out not to be necessary anyway. As much as one’s culture or religion or
beliefs of any sort deserve respect, EJ herself was dead and therefore no
longer in possession of any rights as such (and what if she would not have
objected to testing but had never recorded her views in writing, but her family
were of some devout persuasion and had different ideas?). It seems to me that the coroner should have
had the power to undertake the testing in the circumstances, and if the family
objected once they had been informed they could seek injunctive relief or sue
for damages, assuming they could establish that the coroner’s actions or
intended actions were unlawful.
The
same sort of question arises also in the context of organ donation: a
utilitarian approach would have no hesitation in making organ donation the
default choice at least and perhaps even compulsory irrespective of the wishes
of the deceased, their family or anyone else.
Suppose a wave of zealotry enveloped the population and suddenly no
organs were being donated and no bodies were available to medical science. Latter day Burkes and Hares started to
flourish. Would there not be an argument
for the state to act, even if there was a serious clash with the newly
prevailing religious zeitgeist?
The
second general point concerns the fact that in English law, CM’s actions were
purely voluntary, in direct contrast to the position in most civil law
countries. An interesting post on the case on the UK Human Rights Blog explains the
difference:
[M]ost civil law
countries impose a positive duty to rescue, which means that if a person finds
someone in need of medical help, he or she must take all reasonable steps to
seek medical care and render best-effort first aid. A famous example of this
was the investigation into the photographers at the scene of Lady Diana’s fatal
car accident: they were suspected of violation of the French law of
“non-assistance à personne en danger” (deliberately failing to provide
assistance to a person in danger), which can be punished by up to 5 years
imprisonment and a fine of up to 70,000 euros.
Some food for thought, though for space reasons I will leave
it there for now.
Monday, 24 June 2013
The Telephone Murder, by Ronald Bartle
I have written a review of the above title. The review has been published in the current edition of Criminal Bar Quarterly (Issue 2, Summer 2013, p 14).
Behind the Candelabra, in front of the Bench
I have been published in this week's New Law Journal (vol 163, 21 June 2013, p 30) on Liberace's libel trial. It is available to subscribers here.
Sunday, 23 June 2013
Smith and others v Ministry of Defence [2013] UKSC 41: the fog of war descends on the courtroom
The military theorist von Clausewitz once
said that no plan survives contact with the enemy. Real life confirms it: rare it is that wars ever go to plan. Even in the most successful engagements there have almost always been needless
casualties caused by equipment failure, human error or a combination thereof. In both Gulf Wars, for example, despite the
overwhelming superiority of coalition forces, the very high level of technology
at their disposal, and the swift conclusion of the initial military operations
with extraordinarily low allied casualties, there were still friendly fire incidents
where British and American soldiers were killed by their own side due to
mistaken identity.
Recognising the inevitable
consequences of the “fog of war” and the undesirability of civilian judges
trying to sift through the evidence long after the event, the common law has
developed the doctrine of “combat immunity”, under which anything that happens
during battle is non-justiciable (see for example Shaw
Savill & Albion Co Ltd v Commonwealth (1940) 66 CLR
344, Ex p Marais).
In Mulcahy v Ministry of
Defence [1996] QB 732 the Court of Appeal preferred to see
combat immunity not so much as an entirely separate principle as the result of
a general conclusion that it was not fair, just or reasonable to regard the
Crown or its martial emanations as under a duty of care to avoid injury or
death in their acts or omissions in the conduct of an active military operation
or act of war, but we can leave aside such doctrinal niceties for now.
The families of victims of one friendly
fire incident in the 2003 Iraq war have brought proceedings against the
Ministry of Defence (MOD). The MOD
applied to strike out the claims on the ground of combat immunity. The Supreme Court by a majority decision has
recently ruled against the MOD on that preliminary issue and allowed the claims
to proceed to trial (Smith and others v
Ministry of Defence [2013] UKSC 41). There were claims arising out of different
incidents, but we will confine ourselves here to what were called the “Challenger
claims”. In my view the dissenting
judgment of Lord Mance was compelling.
The decision of the majority to allow the claims to proceed to trial is unsupportable
in principle and may have severe practical implications.
The
Challenger claims involved one British Challenger II tank firing on another,
with fatal consequences. The claimants
alleged that if the tanks had been properly equipped with existing technology
and equipment, the incident would have been prevented.
The majority of the Supreme
Court accepted that combat immunity was not limited to the presence
of the enemy or the occasions when contact with the enemy had been established.
It extended to all active operations against the enemy in which service
personnel were exposed to attack, including the planning and preparation for
the operations in which the armed forces might come under attack or meet armed
resistance. Further, there was no duty, in battle conditions, to maintain a
safe system of work.
However, the doctrine should be narrowly construed. It extended to the planning of and
preparation for military operations applied to the planning of and preparation
for the operations in which injury had been sustained. But it did not extend to the planning and
preparation, in general, for possible unidentified further operations (see Lord
Hope at [88], [92] and [98] of the judgment).
With
respect to the Challenger claims, at the stage when men were being trained,
whether pre-deployment or in theatre, or decisions were being made about the
fitting of equipment to tanks or other fighting vehicles, there was time to
think things through, to plan and to exercise judgment. Those activities were
sufficiently far removed from the pressures and risks of active operations
against the enemy for it not to be unreasonable to expect a duty of care to be
exercised, so long as the standard of care that was imposed had regard to the
nature of those activities and to their circumstances.
Recognising
the dangerous implications, Lord Hope cautioned (at [100]) that:
it is of paramount importance that the work that the armed services do
in the national interest should not be impeded by having to prepare for or
conduct active operations against the enemy under the threat of litigation if
things should go wrong. The court must be especially careful, in their case, to
have regard to the public interest, to the unpredictable nature of armed
conflict and to the inevitable risks that it gives rise to when it is striking
the balance as to what is fair, just and reasonable.
And yet by allowing the case to proceed to trial, Lord Hope with the greatest of respect has not taken account of that paramount importance.
The decision of the majority relies on
the following argument. A casualty might occur due to an equipment problem foreseeable and entirely within the power of the MOD to remedy
before long before the war had started or even looked like starting. If so, why should
the MOD hide behind combat immunity for decisions taken thousands of miles away
and many months before hostilities?
The answer is set out in cutting fashion
by Lord Mance. The supply of technology and
equipment, training for active services, and decisions taken on the ground
during an action are all inevitably inter-linked. The claimants had been careful not to make
any criticism of the commanders on the ground.
But the attribution of responsibility could not depend on how the
claimant framed his case. Lord Hope
recognised the problem but considered that all such circumstances had to be
evaluated with a view to striking a balance between competing considerations. Lord Mance concluded the opposite – that all
such circumstances were inter-related and essentially non-justiciable.
At
para [131] he stated:
The claimants’ case is that during or after any war any injured soldier
or the relatives or dependants of any soldier killed in combat could sue the
state for alleged failures in the preparation or equipping of the armed forces
for combat. Logically, if that is so, then a soldier might, even during the
war, complain that his or her equipment or training was inadequate and that it
would be a breach of the state’s common law duty of care and/or duties under
the Human Rights Convention even to order him or her to go into combat with it.
If domestic legislation compelled this, then the soldier could seek relief in
the Strasbourg court - maybe even interim relief prohibiting the further use or
giving of orders to use the allegedly defective equipment. (…) Pointing to
defective equipment and seeking to ban its use could have a considerable
disruptive effect. Not only would there be a huge potential diversion of time
and effort in litigation of such issues in an area of essential national
interest (whether before, during or after hostilities). There must be risks
that the threat of exhaustive civil litigation following any active military
operation would affect decision- making and lead to a defensive approach, both
at the general procurement and strategic stages and at the tactical and combat
stages when equipment was being deployed.
By way of example he cited a number of
well-known incidents – the defeat at Isandlwana, the failure of the War Office
to appreciate Lancelot de Mole’s idea for the tank in 1912 and the fall of
Singapore. The defeats against the Zulus
and the Japanese involved a number of tactical, planning and equipment
blunders, while it is anyone’s guess what might have happened in the trenches
had de Mole’s suggestion been taken up immediately upon it being made. (Or, one might add, if Whittle's invention had been acted on in the early 1930s.) But a courtroom is not the place to try and
disentangle all of the competing factors and decide what would or could or
should have happened.
The number of further examples that could
be added is limited only by one’s imagination. HMS Hood was known to be
vulnerable to plunging shellfire due to her inadequate deck armament. That
knowledge compelled Admiral Holland to give away his superior position at the
start of the Battle of Denmark Strait, and five minutes later the Hood was
destroyed. Should he have refused to leave port?
Should pilots have refused to fly the Fairy Swordfish, which was known to be hopelessly obsolete in 1939 (but which went on to succeed at Taranto and against the Bismark, but was ruthlessly cut down in the Channel Dash)?
Were casualties incurred during the Falklands because the British boots were unfit for purpose (conceivably, ground could have been covered more quickly otherwise and the troops would have been in better condition when closing with the enemy)?
Should all the politicians of the past two decades be sued because, despite a defence budget as large as the French, the latter manage to develop their own jet (cf the Eurofighter conglomerate fiasco), build their own nuclear powered aircraft carrier (cf the QE class endless delays and cost overruns) and field many more troops?
Why was no-one court martialled over the Royal Marine hostage fiasco in Iran a few years ago (the commander of the boarding party, the ship from which they deployed, and the commander of the fleet in the region would have been good places to start)?
As Adam Wagner pointed out here, it calls to mind the old rhyme
Should pilots have refused to fly the Fairy Swordfish, which was known to be hopelessly obsolete in 1939 (but which went on to succeed at Taranto and against the Bismark, but was ruthlessly cut down in the Channel Dash)?
Were casualties incurred during the Falklands because the British boots were unfit for purpose (conceivably, ground could have been covered more quickly otherwise and the troops would have been in better condition when closing with the enemy)?
Should all the politicians of the past two decades be sued because, despite a defence budget as large as the French, the latter manage to develop their own jet (cf the Eurofighter conglomerate fiasco), build their own nuclear powered aircraft carrier (cf the QE class endless delays and cost overruns) and field many more troops?
Why was no-one court martialled over the Royal Marine hostage fiasco in Iran a few years ago (the commander of the boarding party, the ship from which they deployed, and the commander of the fleet in the region would have been good places to start)?
As Adam Wagner pointed out here, it calls to mind the old rhyme
For want of a nail the shoe was lost.
For want of a shoe the horse was lost.
For want of a horse the rider was lost.
For want of a rider the message was lost.
For want of a message the battle was lost.
For want of a battle the kingdom was lost.
And all for the want of a horseshoe nail.
For want of a shoe the horse was lost.
For want of a horse the rider was lost.
For want of a rider the message was lost.
For want of a message the battle was lost.
For want of a battle the kingdom was lost.
And all for the want of a horseshoe nail.
The answer is that issues arising from
tactical decisions are for military debriefing sessions and, where appropriate,
courts martial. Procurement issues are
for the political process. Neither is
suitable for the civilian courtrooms.
Tuesday, 28 May 2013
Over legislating, over regulating
The Liberal Democrat Peer Lord Phillips of Sudbury (not to be confused with the recently retired head of the Supreme Court, Phillips of Worth Matravers) wrote in Saturday's Telegraph:
Over-legislation and its attendant complexity are bedevilling our whole culture.
On top of the 2,247 pages of primary legislation in 2009, there were around 14,000 additional pages of secondary legislation. This is no less the law of the land, though it receives utterly ineffectual scrutiny by Parliament, because statutory instruments, as they are called, cannot be amended!
Another indication of the self-defeating maze we have fashioned for ourselves is that last year the mere index (the Consolidated Tables) for Halsbury’s Laws of England ran to 3,554 pages.
Other democracies legislate far less. The Coalition, via its Red Tape Challenge, has indicated that it is not mindless of all this, but Parliament has fallen into self-harming ways, which are monumentally difficult to escape.
These include the mandate theory of government, which “entitles” or “requires” the government of the day to pass into law its overflowing basket of election promises. Then the whipping system produces a legislative production-line (only six defeats in more than 3,000 votes between 2001 and 2012). There is also the guillotining of debates, which leaves major parts of most Bills unscrutinised by the Commons.
This is at the root of a dangerous and growing disaffection with democracy. If ever a Royal Commission was essential, one is needed to grapple with these problems.
I have written about this in my book. Experience suggests that red tape has at least two unwanted effects. First, it makes life impossible for small businesses unable to afford regulatory advice (just as we have seen with taxpayers faced with impossibly complex criteria and prospective political parties unable to afford the compliance costs of broadcasting regulations. Secondly, large businesses who can afford the advice will find loopholes to avoid much of the intended outcomes. Not for the first time in human history the only beneficiaries will be the lawyers who make a living selling advice and litigating any resultant disputes, as another Lib Dem peer (also a practising QC) said a few years ago.
The elephant in the room which Lord Phillips ignores is that a substantial percentage of the new statutory instruments he decries are passed each year to implement European Directives. Hence Lord Phillips’ call for a Royal Commission rather misses the point: whilst the United Kingdom remains a member of the European Union there is little it can do about it.
Irrespective of what one thinks of European union as a concept (as distinct from the European Union as an institution), or the overall benefits from Britain’s membership of the EU, it seems to me that there is something of a legal culture clash involved. The clash has been described somewhat crudely in these terms: under English law, in principle everyone is free to do anything that has not been expressly forbidden; under European law systems no-one may do anything unless expressly permitted; and under despotic systems such as the Soviet Union anything citizens were not required to do was prohibited.
Needless to say that is something of a caricature, but it is true that the model of the civil law systems found in Continental Europe is fundamentally different from the common law. Under the former codification is the goal, with much more detailed laws laid down by central government, and no precedent system applied by the courts. Under the common law, the law is supposed to develop according to general principles, with Parliament supreme but much law being made by judges on a case by case basis.
Phillips was therefore right to raise the problem, but I fear that even his suggested Royal Commission might struggle with the solution.
Over-legislation and its attendant complexity are bedevilling our whole culture.
On top of the 2,247 pages of primary legislation in 2009, there were around 14,000 additional pages of secondary legislation. This is no less the law of the land, though it receives utterly ineffectual scrutiny by Parliament, because statutory instruments, as they are called, cannot be amended!
Another indication of the self-defeating maze we have fashioned for ourselves is that last year the mere index (the Consolidated Tables) for Halsbury’s Laws of England ran to 3,554 pages.
Other democracies legislate far less. The Coalition, via its Red Tape Challenge, has indicated that it is not mindless of all this, but Parliament has fallen into self-harming ways, which are monumentally difficult to escape.
These include the mandate theory of government, which “entitles” or “requires” the government of the day to pass into law its overflowing basket of election promises. Then the whipping system produces a legislative production-line (only six defeats in more than 3,000 votes between 2001 and 2012). There is also the guillotining of debates, which leaves major parts of most Bills unscrutinised by the Commons.
This is at the root of a dangerous and growing disaffection with democracy. If ever a Royal Commission was essential, one is needed to grapple with these problems.
I have written about this in my book. Experience suggests that red tape has at least two unwanted effects. First, it makes life impossible for small businesses unable to afford regulatory advice (just as we have seen with taxpayers faced with impossibly complex criteria and prospective political parties unable to afford the compliance costs of broadcasting regulations. Secondly, large businesses who can afford the advice will find loopholes to avoid much of the intended outcomes. Not for the first time in human history the only beneficiaries will be the lawyers who make a living selling advice and litigating any resultant disputes, as another Lib Dem peer (also a practising QC) said a few years ago.
The elephant in the room which Lord Phillips ignores is that a substantial percentage of the new statutory instruments he decries are passed each year to implement European Directives. Hence Lord Phillips’ call for a Royal Commission rather misses the point: whilst the United Kingdom remains a member of the European Union there is little it can do about it.
Irrespective of what one thinks of European union as a concept (as distinct from the European Union as an institution), or the overall benefits from Britain’s membership of the EU, it seems to me that there is something of a legal culture clash involved. The clash has been described somewhat crudely in these terms: under English law, in principle everyone is free to do anything that has not been expressly forbidden; under European law systems no-one may do anything unless expressly permitted; and under despotic systems such as the Soviet Union anything citizens were not required to do was prohibited.
Needless to say that is something of a caricature, but it is true that the model of the civil law systems found in Continental Europe is fundamentally different from the common law. Under the former codification is the goal, with much more detailed laws laid down by central government, and no precedent system applied by the courts. Under the common law, the law is supposed to develop according to general principles, with Parliament supreme but much law being made by judges on a case by case basis.
Phillips was therefore right to raise the problem, but I fear that even his suggested Royal Commission might struggle with the solution.
Sunday, 5 May 2013
Children’s welfare and genetic screening
Introduction
The science of
genetics and genetic engineering has given rise to complex and problematic
ethical issues from its beginning.
Infamously, pseudo-scientific gobbledegook in the form of phrenology was
peddled in the nineteenth century to try and explain criminal behaviour. Even
more infamously, pseudo-scientists attempted in the early twentieth century to
use genetics to advance theories about racial differences.
In both cases the
theories offered were subsequently discredited fairly easily on scientific
grounds, without even needing to question the ethics or motivations of their
proponents. Far from removing the ethical questions with genetic technology,
however, just as many serious moral and ethical philosophical questions
continue to arise with legitimate scientific advancement.
One example is
that of genetic screening of embryos and people to detect potential diseases or
other conditions. On one episode of the BBC’s Moral Maze the question arose as to whether parents could or should
screen embryos before IVF treatment and what might follow from that. A representative of the deaf community opined
that if both parents were deaf, they might wish to choose the embryo that would
produce a deaf child, since they would be able to relate to the child better.
This runs counter to what I imagine would be most people’s instinctive reaction
– that an embryo should be chosen that would be the most ‘able-bodied’ to use a
contentious description. And yet the
argument from the deaf parents’ perspective was a cogent one: life for a deaf
person may be equally fulfilling and certainly is equally worthy of respect as
for someone who can hear, and therefore the parents should not be denied their
choice.
On the other
hand, suppose the parental choice is based on cultural norms that offend that
of the majority: some London hospitals ceased telling parents the sex of unborn
children because it was noticed that within some communities a disproportionate
number of children born were male, and on further investigation it was found
that abortions of female foetuses were commonplace. Here is a classic dilemma
for a multicultural society: given that abortion is legal, did the state have
the right to prevent parents from following a cultural preference for male
children? (In my view: yes).
The case
Another
question arose recently in the case of X
County Council v a mother and others [2013] EWHC 953 (Fam), [2013] All ER
(D) 231 (Apr). The case concerned two young boys (aged one and three) taken
into the care of a local authority, with the intention that they would be
adopted. The father, as well
as admitting violence in the home, said that both his mother and brother
suffered from Huntingdon’s disease (HD).
There was a chance therefore that the children had inherited the gene,
and the question arose as to whether they should be screened to confirm the
question either way.
Huntingdon’s
disease is a hereditary disorder of the central nervous system caused by a
defective gene on chromosome IV. The
faulty gene causes damage of the nerve cells and areas of the brain. Anyone whose parent has the disease is born
with a 50% chance of inheriting the gene.
Anyone who does inherit the gene will develop the disease at some
stage. The symptoms usually arise
between the ages of 30 and 50, though they may do so earlier. The extent of the symptoms varies from person
to person. In the later states of the
disease the physical and mental disabilities may become profound and, if so,
the sufferer will require extensive care and support.
The local
authority took the view that the children should be screened to see whether
they had the gene or not, and applied to the court accordingly. There was no dispute that the power of the court to order a medical or psychiatric examination or other assessment under ss
38(6) to (8) of the Children Act 1989 included screening for HD. It would of
course only make such an order if it thought it was in the interest of the
boys’ welfare.
The judgment
Baker J
considered evidence from the social worker concerning the prospects of
adoption; the evidence that there was that other members of the boys’ family
suffered from HD; and the expert evidence obtained by the parties about
HD.
He recorded the principal
arguments in favour of testing as follows. First, and most importantly, a
decision not to direct genetic testing would reduce the number of prospective
adopters for the boys - though it would not be
impossible. The guardian considered that it was possible to find adoptive
placements for both boys and that accorded with this court's experience. Many
children with profound disabilities were successfully adopted. Nevertheless, it
would be significantly more difficult to find adoptive placements and that was
a factor that pointed in favour of authorising the genetic testing.
Furthermore, his lordship felt that there was considerable force in the argument that matching
children with adopters who were fully informed about the children afforded the
best opportunity for a successful placement.
There were
other factors in favour of authorising testing. As a general rule, all children
had a right to be brought up with knowledge of their background and
inheritance. Unless and until testing was done, there would always be
uncertainty which would affect the children's carers and in due course the
children themselves.
On the other
hand, there were a number of cogent arguments against carrying out testing.
First, it was
the general practice not to provide genetic testing to children to determine
whether they had a condition whose onset occurred in mid-adult life where there
was no treatment which could be provided in childhood. It was generally
recognised that it was contrary to the interests of the patient for testing to
be carried out under the age of 18.
Secondly, it
was undesirable to treat children differently simply because they were being
considered for adoption. Save in exceptional circumstances, all other children
would be given the opportunity to decide for themselves when they were older
whether or not they should have the test. To order testing of the children in
the instant case at the present stage would deny them the right to make their
own decision when they were older.
Thirdly, though
difficult, finding an adoptive placement if there was an unresolved possibility
that the boys might carry the HD gene, would not be impossible.
Finally, when
children had been removed permanently from their birth family, it was
important, if possible, that they be placed permanently together. There was a
significantly greater risk that one boy will be found to carry the gene and the
other not. In those circumstances, there was, on the basis of the local
authority's plans, a significant prospect that the children would ultimately be
separated. That should be avoided if possible.
Baker J
therefore concluded that it was not in the welfare interests of the boys for
the court to order testing.
Comment
I have to say I
think the decision was correct. There was a real risk that the siblings might
be separated if one was found to carry the HD gene and the other not.
Moreover, as
Baker J said, screening would not normally be allowed for children living with
their birth parents. For reasons of
individual autonomy, it would be held that the children should be entitled to
decide from themselves once they became adult (or at least Gillick-competent)
whether they wished to be screened. That
right should not be denied children just because they happen to be on the list
for adoption. This, to my mind, is the
strongest argument, though Rosalind English on the UK Human Rights Blog disagrees. She argues:
Should more weight not have been
attached to the local authority’s case that, from a welfare perspective,
whatever the psychological consequences of testing, they were outweighed by the
likelihood that an unknown diagnosis will significantly decrease the chances of
a successful adoption? (…)
Of course there are adopters who cope
with children with profound disabilities and reduced life expectancy. But these
heroic people are much more likely to be found than to tip up by chance. It is
not sufficient – as the expert argued in this case – simply to educate
prospective adopters about the disorder and in particular how today’s research
is leading to the possibility of treatment in the future, without giving them
the opportunity to know whether this information is going to apply to their
immediate family situation; why else would they be interested? Had this case
not involved two children, with the potential for being separated as a result
of the discovery that one carried the gene and the other not, it is highly
likely that the court would have allowed the predictive testing to go ahead.
Nevertheless, I
still think it would have been wrong in the present case to undertake the
screening. Imagine if, in future, a complete disease/condition screen could be
done of all children. Would that not
render children waiting for adoption to be formed effectively into a queue,
with the least fortune genetic inheritors inevitably forced to the back? It seems to undermine the whole ethos of being
a parent if one’s attitude towards one’s children (adopted or natural) is
conditional upon that child’s genetic good fortune, though an interesting
question would arise if the authority knew that the children carried the HD
gene (or anything similar) and sought to withhold it from prospective
adopters.
But let no-one
assume that this is the last word on the case - still less the last time extremely difficult ethical questions will
arise more generally as a result of advancing genetic science.
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