The Troubled Pregnancy: Legal Wrongs and Rights in Reproduction (Cambridge Law, Medicine and Ethics, Series Number 5)

Mason looks at the legal response to those aspects of the troubled pregnancy which require or involve medico-legal intervention. The unwanted pregnancy is considered particularly in the light of the Abortion Act 1967, s.1(1)(d) and the related action for so-called wrongful birth due to faulty ante-natal care. The unexpected or uncovenanted birth of a healthy child resulting from failed sterilisation is approached through an analysis of the seminal case of McFarlane and associated cases involving disability in either the neonate or the mother. The disabled neonate's right to sue for its diminished life is discussed and the legal approach to the management of severe congenital disease is analysed - thus following Baroness Hale in believing that care of the newborn is an integral part of pregnancy. Aspects are considered from historical and comparative perspectives, including coverage of experience in the USA, the Commonwealth and Europe. Cover......Page 1 Half-title......Page 3 Series-title......Page 4 Title......Page 7 Copyright......Page 8 Dedication......Page 9 Contents......Page 11 Preface......Page 13 Canada......Page 15 European courts......Page 16 United Kingdom......Page 17 United States......Page 24 United Kingdom......Page 27 Human Rights Conventions......Page 29 Introduction......Page 31 Categorisation of the troubled pregnancy......Page 35 The standard of care......Page 39 The Bolam test......Page 40 Causation......Page 42 Introduction......Page 44 Definitions......Page 45 The fetal persona......Page 46 Recognition of fetal status......Page 49 Maternal status......Page 54 The Abortion Act 1967......Page 55 The Abortion Act, section 1(1)(a) in practice......Page 57 A need for reform?......Page 60 Age and termination of pregnancy......Page 62 Prevention and reversal of implantation......Page 65 A duty to the mother......Page 68 Involuntary termination of pregnancy......Page 71 Fetal death, fetal status and the criminal law......Page 72 The case of Vo v. France......Page 74 Conclusion......Page 79 Do we need an offence of feticide?......Page 80 Introduction......Page 83 Late termination of pregnancy......Page 84 The uncertainties of subsection 1(d)......Page 87 Congenital disease......Page 89 Investigations available in the face of potential fetal abnormality......Page 93 Maternal testing......Page 94 The principles of antenatal care......Page 96 Antenatal counselling......Page 97 Information based negligence......Page 98 The development of the wrongful birth action......Page 109 Early experience in the United States......Page 110 Developments in the Commonwealth......Page 112 The development of ‘wrongful birth’ in the United Kingdom......Page 113 Recompense for wrongful birth in the United Kingdom......Page 114 Wrongful birth during and after McFarlane......Page 115 Conclusions......Page 127 Negligent sterilisation......Page 130 The duty of care......Page 133 Liability and wrongful pregnancy......Page 135 The transatlantic experience......Page 136 Historic wrongful pregnancy in the United Kingdom......Page 138 The case of Mr and Mrs McFarlane......Page 142 McFarlane in the House of Lords......Page 143 Wrongful pregnancy in Australia......Page 155 The case of Mrs Melchior......Page 156 Lessons from a legal ‘test match’......Page 168 McFarlane under fire......Page 171 A connecting case......Page 175 Second-guessing the House of Lords......Page 180 The pre-McFarlane position......Page 182 Mrs Parkinson’s case......Page 183 The disabled mother......Page 193 Ms Rees’s case......Page 194 Rees in the House of Lords......Page 196 McFarlane, Parkinson and Rees in perspective......Page 199 Deconstructing the decision in Rees......Page 203 The conscience of the Lords......Page 206 The proximity test......Page 213 Introduction......Page 218 The wrongful life action in history......Page 219 Wrongful life in the United States......Page 221 The perspective in the United Kingdom and the Commonwealth......Page 234 The case of Mary McKay......Page 235 The Congenital Disabilities (Civil Liability) Act 1976......Page 240 Wrongful life in Australasia......Page 243 A Canadian anomaly......Page 254 Wrongful life in Europe......Page 262 Conclusion......Page 267 Introduction......Page 271 The sanctity of life......Page 273 The quality of neonatal life......Page 274 Principles of management of severe congenital disease......Page 275 The ‘best interests’ test......Page 276 The British cases......Page 280 The 1981 cases......Page 282 Development of the jurisprudence since Re B......Page 290 The recent cases......Page 303 Professional guidelines......Page 320 Neonatal euthanasia......Page 323 Addendum......Page 326 Patterns and anomalies......Page 327 The fetal status – again......Page 329 Legal or moral principle?......Page 331 Bibliography......Page 333 Index......Page 342 Cover 1 Half-title 3 Series-title 4 Title 7 Copyright 8 Dedication 9 Contents 11 Preface 13 Table of cases 15 Australia 15 Canada 15 European courts 16 France 17 Hong Kong 17 Israel 17 Netherlands 17 New Zealand 17 South Africa 17 United Kingdom 17 United States 24 Table of statutes 27 Australia 27 New Zealand 27 United Kingdom 27 United States 29 Human Rights Conventions 29 1 The nature of the troubled pregnancy 31 Introduction 31 Categorisation of the troubled pregnancy 35 An overview of medical negligence 39 The duty of care 39 The standard of care 39 The Bolam test 40 The patient’s decision 42 Causation 42 2 Voluntary and involuntary termination of pregnancy 44 Introduction 44 Definitions 45 The fetal persona 46 Recognition of fetal status 49 Maternal status 54 The Abortion Act 1967 55 The Abortion Act, section 1(1)(a) in practice 57 A need for reform? 60 Age and termination of pregnancy 62 Prevention and reversal of implantation 65 Negligence and abortion 68 A duty to the mother 68 Involuntary termination of pregnancy 71 Fetal death, fetal status and the criminal law 72 The case of Vo v. France 74 Conclusion 79 Do we need an offence of feticide? 80 3 Antenatal care and the action for wrongful birth 83 Introduction 83 Late termination of pregnancy 84 The uncertainties of subsection 1(d) 87 Antenatal care and fetal abnormality 89 Congenital disease 89 Investigations available in the face of potential fetal abnormality 93 Maternal testing 94 The principles of antenatal care 96 Antenatal counselling 97 Information based negligence 98 The development of the wrongful birth action 109 Early experience in the United States 110 Developments in the Commonwealth 112 The development of ‘wrongful birth’ in the United Kingdom 113 Recompense for wrongful birth in the United Kingdom 114 Wrongful birth during and after McFarlane 115 Conclusions 127 4 Unsuccessful sterilisation 130 Introduction 130 Negligent sterilisation 130 The duty of care 133 Liability and wrongful pregnancy 135 The transatlantic experience 136 Historic wrongful pregnancy in the United Kingdom 138 The case of Mr and Mrs McFarlane 142 McFarlane in the House of Lords 143 Wrongful pregnancy in Australia 155 The case of Mrs Melchior 156 Lessons from a legal ‘test match’ 168 McFarlane under fire 171 A connecting case 175 5 Uncovenanted pregnancy and disability 180 Introduction 180 Second-guessing the House of Lords 180 The disabled neonate 182 The pre-McFarlane position 182 Mrs Parkinson’s case 183 The disabled mother 193 Ms Rees’s case 194 Rees in the House of Lords 196 McFarlane, Parkinson and Rees in perspective 199 Deconstructing the decision in Rees 203 The conscience of the Lords 206 The proximity test 213 6 Wrongful neonatal life 218 Introduction 218 The wrongful life action in history 219 Wrongful life in the United States 221 The perspective in the United Kingdom and the Commonwealth 234 The case of Mary McKay 235 The Congenital Disabilities (Civil Liability) Act 1976 240 Wrongful life in Australasia 243 A Canadian anomaly 254 Wrongful life in Europe 262 Conclusion 267 7 The management of the disabled neonate 271 Introduction 271 The sanctity of life 273 The quality of neonatal life 274 Principles of management of severe congenital disease 275 Medical futility 276 The ‘best interests’ test 276 The British cases 280 The 1981 cases 282 Development of the jurisprudence since Re B 290 The recent cases 303 Professional guidelines 320 Neonatal euthanasia 323 Addendum 326 8 Conclusion 327 Patterns and anomalies 327 Conflicts of values 329 The fetal status – again 329 Legal or moral principle? 331 Bibliography 333 Index 342 Mason explores aspects of pregnancy which involve medico-legal intervention, including unwanted or undesired pregnancies