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ABC v St George’s Healthcare NHS Trust and Others [2017] EWCA Civ 336 – read judgment
All the advocates in this case are from 1 Crown Office Row. Elizabeth-Anne Gumbel QC, Henry Witcomb QC and Jim Duffy for the Appellant, and Philip Havers QC and Hannah Noyce for the Respondents. None of them were involved in the writing of this post.
In a fascinating twist to the drama of futuristic diagnosis, the Court of Appeal has allowed an argument that doctors treating a Huntington’s patient should have imparted information about his diagnosis to his pregnant daughter to go to trial.
The background to this case is outlined in my earlier post on Nicol J’s ruling in the court below. A patient with an inherited fatal disease asked his doctors not to disclose information to his daughter. The daughter came upon this information accidentally, shortly after the birth of her child, and found, after a genetic test, that she suffered from this condition as well, which has a 50% chance of appearing in the next generation. Had she known this, she would have sought a termination of the pregnancy. She claimed that the doctors were liable to her in damages for the direct effect on her health and welfare.
A claim for “wrongful birth” is well established in law; no claim was made on behalf of the child, who was too young to be tested for the condition. The twist is the duty of secrecy between doctor and patient, which has held very well for the past two centuries. Short of confessions pertaining to homicide or information regarding contagious diseases, the dialogue behind the consulting door should end there.
The problem is that the typical medical relationship only pertains to the pathology of the individual patient. Now that tests are available that make every single one of us a walking diagnosis not only for our own offspring but those of our siblings and their offspring, the one-to-one scenario collapses, along with the limited class of people to whom a doctor owes a duty of care. The pregnant daughter who came across the information about her father’s condition was not the defendant doctor’s patient. In pre-genetic days, that meant there was no duty of care relationship between her father’s doctors and her. But the certainty of hereditability brings her into that circle. Continue reading →
In the current circumstances, this case has important resonances and maybe even implications for future vaccinations. It was an appeal by the parents of a ten year old child against a decision that the local authority, had lawful authority to have the child vaccinated (pursuant to Section 33(3) of the Children Act 1989.
The local authority had made care and placement orders in respect of the child, who was at the time in foster care. The LA argued that it had lawful authority, pursuant to the Children Act 1989 s.33(3), to arrange the vaccination of a child in care notwithstanding the objection of the parents, and that therefore it was unnecessary and inappropriate to refer the decision to the High Court under its inherent jurisdiction. Parental views regarding immunisation had always to be considered but the decision depended solely on the child’s welfare.
Conor Monighan brings us the latest updates in human rights law
In the News:
Credit: The Guardian
The House of Commons has passed amendments which are likely to liberalise the law on abortion and same-sex marriages in Northern Ireland.
The amendments were added to the NI Executive Formation Bill. The first was put forward by Conor McGinn (Labour). It states that if the NI Assembly is not restored by the 21st October, the government must create secondary legislation to allow same-sex marriage in Northern Ireland. This means there will be no further debate in the House of Commons, because the government will make use of regulations. The second amendment, tabled by Stella Creasy (Labour), has a similar effect. However, both are subject to the condition that the Northern Irish Assembly can legislate to change the law.
Prior to the vote, Ms Creasy said “At this moment in time, if somebody is raped in Northern Ireland and they become pregnant and they seek a termination, they will face a longer prison sentence than their attacker”.
The Conservative leadership contenders were split on the vote. Boris Johnson stated that both subjects were devolved matters, whilst Jeremy Hunt voted for both proposals. Karen Bradley (the Northern Ireland Secretary) and Theresa May (PM) abstained.
Unusually, MPs in the Scottish National Party were given a free vote. The party ordinarily abstains from voting on devolved issues in other countries. Continue reading →
Carter v. Canada (Attorney General), 2015 SCC 5 (CanLII) 6 February 2015 – read judgment
The Supreme Court of Canada has upheld a challenge to the constitutionality of the prohibition on assisted dying, saying that since they last ruled on this issue in the 1993 case of Rodriguez (where a “slim majority” upheld the prohibition), there had been a change in the circumstances which “fundamentally shifted the parameters” of this debate.
The Court issued a declaration of invalidity relating to those provisions in the Canadian criminal code that prohibit physician assisted dying for competent adults who seek such assistance as a result of a “grievous and irremediable” medical condition that causes “endurable and intolerable” suffering. These laws should be struck down as depriving those adults of their right to life, liberty and security of the person under Section 7 of the Canadian Charter of Rights (The Constitution Act 1982)
Importantly, the court recognised what has long been proposed by campaigners on both sides of the Atlantic, that the prohibition deprives some individuals of life, as it has the effect of forcing people to take their own lives prematurely, for fear that they would be incapable of doing so when they reached the point where suffering was intolerable. Continue reading →
A historic deal has been agreed at the United Nation’s Cop27 summit which will provide funding to vulnerable countries to cope with the impact of climate change. The final cover document did not include commitments to reduce the use of fossil fuels. The deal also used new ambiguous language about “low emissions energy” which experts suggest could refer to fossil fuels including gas.
There has been an investigation following the appearance of sexual abuse victims’ personal details on the Suffolk Police website. Police and crime commissioner Tim Passmore issued an “unreserved apology” for the breach. The published information included victims’ names, addresses, dates of birth and details of the offences committed against them.
On Monday 14 November, the United Nations Human Rights Council released a report which including 302 recommendations demanding that the UK must tackle rising poverty. The report follows new figures revealing that four million children in households on universal credit face big cuts in income if benefits are not increased in line with inflation. Oxfam and the Healthcare Trade Unison, amongst other organisations, have said the UK is “failing to meet its international legal obligations”.
In other news:
The Refugee Council called on ministers to introduce a range of measures to deal with the record delays in processing asylum claims. Currently, government spending is at around £6.8million for housing migrants in hotels. It has also been revealed that at least forty child asylum seekers were placed in a Home Office hotel designated for adults; last month, one child was the victim of a serious stabbing.
The Advertising Standards Authority (ASA) has revised its guidance on age-restricted ads online. The new guidelines provide greater protection to children and young people by introducing content, media placement and audience targeting restrictions. The Committee of Advertising Practice (CAP) provided a principles-based checklists to help limit the exposure of young people and children to age-restricted ads. Advertisers have ultimate responsibility for ensuring compliance with the rules.
Analysts at the Internet Watch Foundation (IWF) revealed they found nearly nine-hundred instances of Category A child sexual abuse material in just five days. The research revealed children as young as seven are being coerced by abusers into filming themselves carrying out the most severe forms of child sexual abuse material. The data publication has been used to highlight the need for the delayed Online Safety Bill.
In the courts
In X, Re (Catastrophic Injury: Collection and Storage of Sperm) [2022] EWCOP 48, the Court of Protection dismissed an application by X’s parents, V and W, for a declaration that it would be lawful for a doctor to retrieve X’s gametes to be stored both before and after his death, and an order that V may sign the relevant consents in accordance with the provisions of sub-paragraph 1(2) of Schedule 3 to the Human Fertilisation and Embryology Act 1990 (“The 1990 Act”). Schedule 3 of the 1990 Act deals with the use or storage of gametes, as does Section 4(1) of the 1990 Act; both stress the importance of consent in order that this activity be effectively regulated. X was potentially to be assessed as brain dead within 24 hours of the hearing. Citing Parrillo v. Italy (Application no. 46470/11) the Court held that the ability to give consent in regards to gametes or embryos constitutes a facet of private life. The Court relied upon K v LBX and others[2012] EWCA Civ 79 in establishing that for an interference with X’s Article 8 rights to be lawful, it must be necessary and proportionate to achieve a legitimate aim. Having considered all the circumstances, and applying section 4 of the Mental Capacity Act 2005, the Court held that it would not be in X’s best interests to make the declarations sought. The Court was not persuaded that the significant interference with X’s Article 8 rights would be necessary or proportionate.
On 18 November, judgement was handed down in AG (A Child), Re [2022] EWCA Civ 1505. The Court dismissed an appeal against the decision of the Divisional Court to refuse to make a declaration of incompatibility between certain provisions of the Diplomatic Privileges Act 1964 (DPA) and the Vienna Convention on Diplomatic Relations 1961 (VCDR) with Article 3 of the European Convention on Human Rights and Fundamental Freedoms (ECHR). The key issue in the appeal was whether the Divisional Court was right to decide that neither Article 3 nor ECtHR jurisprudence required the UK to breach the VCDR. The Appellant, AG, and her 5 siblings were subjected to abuse by both their parents. Their father was an accredited diplomat at the time and thus had immunity from the criminal, civil and administrative jurisdiction of the receiving state under DPA and the VCDR. Barnet, the London Borough where the family lived, tried to intervene on the children’s behalf, and supported AG in the appeal. The Appellant contended, referencing Z v United Kingdom (Application no. 29392/95), that Article 3 includes a systems duty on the state to take effective measures to prevent private acts of torture, inhuman or degrading treatment or punishment. The Court were unpersuaded by this. Relying upon Lord Reed’s judgement in R (AB) v Secretary of State for Justice[2022] AC 487, the Court held that they could not be confident that the ECtHR would regard the systems duty in Article 3 as overriding the long-established international law principles enshrined in the VCDR and it was not open to the court to declare Article 3 and the VCDR incompatible.
A woman living with Autistic Spectrum Disorder (“ASD”), absence epilepsy and learning difficulties succeeded in a claim for judicial review against the London Borough of Croydon after a deputy High Court judge ruled that the council had failed to meet her needs contrary to the requirements of the Care Act 2014. The claim in P, R (On the Application Of) v London Borough of Croydon[2022] EWHC 2886 (Admin) contended that the council’s decision to fund 35 hours per week of support was unlawful as it failed to meet her needs, and succeeded on three of four grounds.In relation to Ground 1, the Judge observed that it was arguably unlawful for the Defendant to have set a level of required care in an assessment, and then to have provided a Care and Support Plan making assumptions that the required care could be provided by her parents. Grounds 3 and 4 both concerned a failure to comply with The Care and Support Statutory Guidance. The Court held, referring to the standard of proof established in R (Cava Bien Ltd) v Milton Keynes Council[2021] EWHC 3003, that the Defendant’s apparent failure to asses the level of care which could and would be provided by the Claimant’s parents did make a substantial difference to the outcome of the Claimant’s care assessment. The Court ordered the quashing order of the Defendant’s February 2022 decision to provide or fund 35 hours of support per week, and the Defendant’s Care and Support Plan dated 14 February 2022. With reference to R (CP) v North East Lincolnshire Council[2019] EWCA Civ 1614, the Court maintained that it was not unconcerned with “historic” breaches and the Claimant was entitled to declaratory relief on this aspect of Ground 1.
Airport expansion has taken a long and winding road, not least at Heathrow. But the proponents of the 3rd runway at Heathrow would have been heartened by the Secretary of State’s decision in June 2018 to set out a policy which preferred Heathrow over Gatwick and which was designed to steer planning processes thereafter in support of the new runway.
It is this decision which has just been declared unlawful by the Court of Appeal.
I am afraid this is where the planning jargon starts and the acronyms proliferate. The challenged decision was an Airports National Policy Statement (ANPS). Under planning legislation, an ANPS “sets the fundamental framework within which further decisions will be taken,” as the CA put it in [275]. Those further decisions include the grant of permission for the particular project, done through the Development Consent Order (DCO) process. But you cannot challenge that fundamental framework later in the DCO process; you cannot say later, for instance, that expansion is not necessary at all, or there is a better alternative, say, Gatwick, if the ANPS has decided otherwise.
The following piece was first published on the UK Constitutional Law Blog on 25 April 2024 and is reproduced here with their permission, for which the editors are grateful
Commentary on the Safety of Rwanda (Asylum and Immigration) Act (“RA”), which is shortly to receive Royal Assent, has concentrated principally on its deeming of Rwanda as a safe country whilst ousting the supervision of courts. This post considers a separate issue – section 4 of the Act as it applies to victims of slavery (“VOS”). Section 4 provides a carve out from the Act’s deeming provisions where the Home Secretary considers Rwanda is unsafe for an individual “based on compelling evidence relating specifically to their particular individual circumstances”. It also providescourts with a power of review of that question.
This post argues that, read in the light of the common law constitutional prohibition of slavery (“POS”), s.4 should prevent all suspected and confirmed victims of slavery from being removed against their will to Rwanda without, at the least, a detailed assessment of their specific risks of re-trafficking there.
The October 2014 Conservative Party proposals promised to:
End the ability of the European Court of Human Rights to force the UK to change the law. Every judgement that UK law is incompatible with the Convention will be treated as advisory and we will introduce a new Parliamentary procedure to formally consider the judgement.
In the event that we are unable to reach that agreement, the UK would be left with no alternative but to withdraw from the European Convention on Human Rights, at the point at which our Bill comes into effect.” (see proposals here )
The Conservative Party’s manifesto included a much shorter summary of the proposals without the specific details about the relationship with the ECtHR of the Council of Europe and the Queen’s Speech on 27th May promised that there would be a consultation exercise (see summary here) Continue reading →
The Queen’s speech suggests a slowing of the Government’s plans to replace the Human Rights Act with a British Bill of Rights. But recent comments from the Scottish Human Rights Commissioner suggest the Conservatives may be considering removal of HRA protections in relation to English and reserved UK-wide matters only, leaving the Human Rights Act in place in the other devolved areas of the UK.
by David Scott
Much ink has been spilled over the Government’s proposals. This article will take a narrow look at Scotland’s relationship with the Human Rights Act, and how devolution may be a future thorn in the Government’s side.
But wait! I thought the Human Rights Act was enshrined in the Scotland Act. Doesn’t that protect the Human Rights Act in Scotland?
On Thursday, Harry Dunn’s family were granted permission to appeal against the High Court ruling handed down on 24 November, which held in no uncertain terms that Mrs Sacoolas did enjoy diplomatic immunity at the time she killed 19 year-old Harry Dunn while driving on the wrong side of the road in August of last year. The US state department has refused to waive her immunity under Article 32 of the Vienna Convention on Diplomatic Relations, stating that to allow the waiver, and thereby the extradition request that would inevitably follow would set an “extraordinarily troubling precedent”. The arrests of diplomats Michael Kovrig in China and Rob Macaire in Iran over the last year highlight the continued importance of the inviolability of diplomatic agents serving abroad. However, where there has been an unlawful killing by a family member of an agent, natural inclinations of justice are upset by the failure of a longstanding diplomatic ally to simply do the right thing.
In this carefully nuanced judgment, the Court of Protection has ruled that although a patient with a chronic eating disorder would in all probability face death she did not gain weight, it would not be in her best interests to continue being subjected to forced feeding inpatient regimes.
AB is a 28 year-old woman who has over many years suffered from anorexia nervosa. She was first diagnosed when she was a teenager of 13 and now has a formal diagnosis of a Severe and Enduring Eating Disorder (‘SEED’).
The NHS Trust and the team of treating clinicians who have been responsible for providing care for AB applied to the COP for declaratory relief pursuant to ss 4 and 15 of the Mental Capacity Act 2005 in these terms: (i) it is in AB’s best interests not to receive any further active treatment for anorexia nervosa; and that (ii) AB lacks capacity to make decisions about treatment relating to anorexia nervosa.
Issues before the Court
Litigation capacity: it was not in issue that AB did have the capacity to instruct her solicitors.
General capacity: this was a more difficult question to be decided under Section 3 of the Mental Capacity Act. The key question was, did she have the mental capacity to make a decision about the specific medical treatment proposed. Roberts J had to decide one way or another on whether she should be tube fed, probably under sedation (otherwise she would remove the tube).
The Trust argued that she did not have this capacity, relying on evidence from AB’s treating psychiatrist Dr B. AB said she did have this capacity.
Best interests: was it in AB’s interests to discontinue any tube feeding? The unanimous professional view of her treating team was that palliative care and no further tube feeding was in her best interests. However, since the decision not to have any further forced feeding was a life-threatening one, the case had to be referred to the Court of Protection.
The Appellant in R (on the application of Elan-Cane) (Appellant) v Secretary of State for the Home Department (Respondent) [2021] UKSC 56 was assigned female at birth, however during and after puberty they felt revulsion at their body and underwent surgery in 1989 and 1990 to alleviate those feelings. The Appellant who identifies as non-gendered, is a campaigner for the legal and social recognition of this category. The provision of “X passports” are a focal point of the Appellant’s campaign.
A bank requires its would-be recruits and some of its existing employees to undergo a medical. It sends them to the home of one particular, self-employed doctor. There, they undergo a medical examination, unaccompanied by anyone from the bank.
The doctor completes the bank’s proforma examination form, headed with its logo and entitled “Barclays Confidential Medical Report”. The form is detailed. It includes sections on chest “Inspiration” and “Expiration”, “Abdomen (including Genito-Urinary System)”. It contains a section for “Female applicants only”, asking whether they have suffered from menstrual or pregnancy disorders.
The doctor – Gordon Bates – subsequently dies. A large group of women sue the bank alleging that it is liable for sexual assaults carried out by the doctor during the examinations. The question for the Court of Appeal in Barclays Bank plc v Various Claimants[2018] EWCA Civ 1670 was whether the bank could be vicariously liable.
Background
Following Dr Bates’ death in 2009, 126 women came forward alleging that he had abused them during medical examinations carried out on behalf of Barclays between around 1968 and 1984. The police concluded in 2013 that, had he been alive, there would have been sufficient evidence to pursue a criminal prosecution against him.
On Wednesday, Boris Johnson gave oral evidence to the Privileges Committee as part of an ongoing inquiry into whether the ex-Prime Minister misled Parliament over lockdown parties in No 10. If the Commons was misled, the Committee will determine whether that constituted a contempt of Parliament – a finding which could result in Mr Johnson’s suspension from the Commons. In his evidence, Mr Johnson accepted he mislead MPs, but that he had not done so “intentionally or recklessly”. He claimed his statements were based upon honest belief, and were made in ‘good faith’ and in reliance on ‘trusted advisers’. The outcome of the inquiry will largely rest on whether Mr Johnson inadvertently, deliberately, or recklessly mislead Parliament – with the most severe sanctions arising if he is found to have deliberately made false statements to MPs. The committee’s report is expected later in the year.
Baroness Casey’s final report on the standards of behaviour and internal culture of the Metropolitan Police Service was published this week. The review was commissioned following the death of Sarah Everard at the hands of a serving Met officer. The report describes a culture in the Met of ‘defensiveness and denial’, which lacks integrity, fails to take complainants seriously and has discrimination ‘baked into it’. In Baroness Casey’s own words: ‘we have found institutional racism, misogyny and homophobia in the Met’. This report, alongside tragic events like Ms Everard’s death and the recent conviction of long-serving Met officer David Carrick, highlight a loss of public confidence in the police force.
In France on Thursday, protesters gathered across the country to demonstrate their opposition to President Macron’s pension reform bill, which proposes raising the age of retirement from 62 to 64. The protests began in January, but escalated this week when President Macron forced the proposed bill through parliament without a vote in the National Assembly. It is estimated that approximately one million people took part in the demonstrations. In Bordeaux, the front door of the city’s town hall was set on fire and police have been accused of using excessive force against protesters. Before the bill becomes legislation, it must pass a review by the Constitutional Council.
Mentally incapacitated people have the same rights to liberty as everyone else. If their own living arrangements would amount to a deprivation of liberty of a non-disabled individual then these would also be a deprivation of liberty for the disabled person. So says the Supreme Court, which has ruled that disabled people are entitled to periodic independent checks to ensure that the deprivation of liberty remains justified. Continue reading →
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ABC v St George’s Healthcare NHS Trust and Others [2017] EWCA Civ 336 – read judgment
A bank requires its would-be recruits and some of its existing employees to undergo a medical. It sends them to the home of one particular, self-employed doctor. There, they undergo a medical examination, unaccompanied by anyone from the bank. 
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