Cate Howell, General Practitioner, Primary Care Mental Health Unit, Discipline of General Practice, Adelaide
Disputes and Dilemmas in Health Law is an Australian book which explains that health law is significant because it reflects on fundamental issues that impact on the beginning, end and quality of life. The book is divided into sections on health law and ethical dilemmas, human rights, public health, reproductive technologies, the end of life, litigation and liabilities, and privacy and confidentiality. The contributors include many eminent Australian legal and medical experts.
There is discussion about the 'ethics of care', and the relationship between ethics and law is explored. Law deals with practical issues, such as resolving disputes, and focuses on facts, but has limitations in dealing with moral issues. The ethical and legal issues related to advance directives, and competency to consent are explained, and information is provided about legislation in different Australian states.
Public health law covers environmental health issues and the control of disease and drugs. It is a critical area for prevention of many illnesses and dealing with epidemics. International issues such as the impact of trade agreements on health and practice are explored.
Issues related to the end of life are covered, including legislation in relation to the coroner, organ donation and end-of-life decisions. Legal cases concerning the insistence of families that life-sustaining treatment be continued in situations of overwhelming illness are discussed.
The section on litigation and liability covers medical negligence law. The question of whether a doctor has breached duty of care is discussed and the Bolam principle described. This principle was rejected in an Australian case, however, a modified form has been introduced as part of a review of tort reforms in Australia. 'A professional does not incur a liability in negligence... if it is established that [they] acted in a manner that† was widely accepted by peer professional opinion as competent professional practice'.
The final section looks at privacy and confidentiality. Disputes about confidentiality are only a recent phenomenon. Much discussion relates to HIV infection, in which a balance is sought between protecting the individual from discrimination and ensuring public safety. The obligations relating to privacy of information and allowing access to records are reviewed. The impact of legislative changes on records is discussed as well as issues relating to the electronic transfer of information.
Disputes and Dilemmas in Health Law is presented in a clear and readable manner. One can focus on topics of particular relevance, but it is likely that the reader will find the text engaging enough to read much more broadly. It contains important information for all practitioners, and there are many topics directly relevant to general practitioners. The book achieves its aims by providing clear and comprehensive information, and by provoking thought about ethical and legal aspects of health care.
