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Reviews

Medical Law

  • Book by Jo Samanta and Ash Samanta (£24.95, Palgrave Macmillan, 2011)
  • Reviewed by Dr Simon Paul FRCP (UK), Consultant Rheumatologist, Kingston Upon Thames

If you have ever looked for a book on medical law that manages to balance an exposition of historical medical jurisprudence and ethics, academic debate, insightful critiques of the contemporary UK healthcare situation, a thorough exploration of current medical law and future challenges, all interwoven with stimulating discussions using real life practical dilemmas, then this book might be for you! Medical Law, written by a husband and wife couple, stands out from most recent medical law texts in many respects. 

Firstly, the authors come from nursing and medical backgrounds, but are also law lecturers. Undoubtedly, their practical experience of healthcare settings, enhanced by their legal backgrounds, provides a unique insight into medical law. The authors illustrate topics with authoritative case law, and where relevant, primary and secondary legislation. Refreshingly, the authors also manage to discuss obiter dicta (persuasive statements made in passing by judges, which although not binding, may be influential on later decisions), something which many other books sadly fail to do.

It was nice to see comparative analyses of case law and legislation from other (non-UK) jurisdictions, eg, in the section on assisted dying, and also discussion on relevant EU law. It is extremely well priced at £24.99 and the reader can additionally benefit from access to an easy to use companion website to get topic updates (but interestingly I could not find an entry on the website relating to the Supreme Court landmark ruling Jones v Kaney [2011] that removed expert witness immunity).

Each chapter begins with a topic map and this serves to put subjects into neat headings. The chapters comprise: The Scope and Nature of Medical Law and Ethics; The Contemporary Healthcare Environment; Clinical Negligence; Capacity and Consent to Medical Treatment; The Beginning of Life; Children; Clinical Research; Human Tissue and Transplantation; Mental Health Law; The End of Life; and Future Challenges.

All apart from the last chapter are fairly standard stock in medical law texts, so it was good to see the last chapter included. It would have been nice to see more on the broader changes brought by the Coroners and Justice Act 2009, and more detailed explanation of the regulation of healthcare professionals. Also, I would have preferred to have seen more discussion on methods of alternative dispute resolution and legal processes from service of claim to settlement, maybe as appendices, or in the chapter on clinical negligence.

The authors develop the reader’s understanding using practical scenarios to illustrate important but not straightforward principles

As expected, there are areas of medical law which overlap chapters, (eg, consent in chapters on mental health law, ethics and research) but topic analyses are not duplicated in the chapters; if anything, they are developed in subsequent sections. I found it more helpful to read the end of chapter summaries at the beginning to help signpost how the chapters evolve, but that is only a personal preference. The authors develop the reader’s understanding using practical scenarios to illustrate important but not straightforward principles.

Key terms are expanded for the reader with little background knowledge, but these are also useful for those with more experience in the area as aide memoires. A minor criticism is I found the text blocks a little hard to wade through in places – this is not unusual in books that tackle medical law and ethics, but in general, good use is made of headings and subheadings to break up the text. The book is sufficiently indexed and suggestions for further reading are provided, which mostly appeared relevant.

Overall, I would highly recommend Medical Law, a book that manages to bridge the gap between an introductory and more substantive textbook. It will appeal to law and medical students who have chosen medical law modules, but will also appeal to postgraduate medical and other healthcare practitioners. Lawyers with an interest in medical law will find this a useful general textbook.

CliniCalc app

  • Reviewed by Dr Laura Davison, GP in Milton Keynes

Have you ever been clerking in a patient and just cannot remember what the four E’s of the Glasgow Coma Scale are, or remember which dermatome those shingle-like vesicles seem to be following? Ever needed to urgently calculate The Delta Gap and Ratio... well, probably not that last one, but the point of new app, CliniCalc, is that if you wanted to, you could.

This very thorough and clever little app covers a multitude of clinical scoring systems, risk evaluators and physiological calculations. Its breadth should mean it applies to both primary and secondary care doctors, from junior to consultant level. The coverage is wide ranging, from the bamboozling anaesthetic and nephrology calculators, to the simplicity of BMI and GCS.

There are numerous lifestyle and cardiac risk categories too, applicable to general practice; however, the majority of modern operating systems for GPs now have these already incorporated.

There are so many calculations on this app, to be honest I had not heard of half of them, and as good as the program is at telling you how it worked it out, it cannot tell you what to do with the results at the end of it.

But I guess that is why we went to medical school. The only obvious omission I’ve noted is the Rockall Score for gastrointestinal bleeds, but perhaps this could be included in a future upgrade. My only concern is that you can waste minutes flicking through the various category screens hunting for the calculator you need.

As good as the program is at telling you how it worked it out, it cannot tell you what to do with the results at the end of it

There is an option on the app to save certain calculations to your “Favourites”. Overall a useful application to put on your smartphone, to whip out for patient care decisions or showing off your thoroughness on the ward round, and if you do not use it in the end, who cares, it is free to download from the Apple App Store. So if it is no use to your practice, just delete and replace it with another upgrade of Angry Birds.

CliniCalc is yet to be released for the Android market.

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