Reflecting the international experience, statistics show that most medical negligence cases in Ireland settle. Less is known, however, about the duration of these cases, though anecdotal evidence suggests that they are protracted in nature. Procedurally focused reforms, aimed at reducing costs and facilitating more expedient resolution of these disputes have been proposed in Ireland, yet await implementation. As such, the pace of litigation is largely determined by the parties to the dispute. Drawing on the findings of an empirical study (an analysis of closed case files and qualitative interviews), this article explores two questions: first, how long do medical negligence cases take to resolve; and secondly, what contributes to delay in this context. Whilst causes of delay may vary by case, it is important to attempt to identify and explore common factors which contribute to delay. If these factors can be problematised and understood, possible solutions may be reached. In doing so, the article contributes to the debate on medical negligence reform across common law jurisdictions, evidencing the broader considerations, in addition to procedurally focused reforms, which are required when considering the issue of delay.

Antipsychotics and severe mental illness (SMI) are associated with weight gain, and obesity increases the risks of cardiometabolic disease and premature death. These present management and liability issues for psychiatrists. Physical healthcare for people with SMI is poor, and this may partly be owing to training limitations and lack of proactiveness by psychiatrists. Ethically and legally, psychiatrists have a duty to avoid unnecessary harm and to maintain an acceptable standard of care. This would apply particularly to patients receiving compulsory treatment for their SMI owing to their vulnerability. Discrepancy between psychiatric and non-psychiatric approaches to pharmacological treatment creates ambiguity, and weight gain could demotivate antipsychotic adherence. This article explores how the Mental Health Act could be used to address these issues, and the ethical considerations, and proposes how long-acting glucagon-like peptide-1 receptor agonists could be introduced into existing psychiatric practice as a treatment option for antipsychotic-induced weight gain and obesity in SMI.

The cost of clinical negligence claims continues to rise, despite efforts to reduce this now ageing burden to the National Health Service (NHS) in England. From a welfarist perspective, reforms are needed to reduce avoidable harm to patients and to settle claims fairly for both claimants and society. Uncertainty in the estimation of quanta of damages, better known as financial settlements, is an important yet poorly characterised driver of societal outcomes. This reflects wider limitations to evidence informing clinical negligence policy, which has been discussed in recent literature. There is an acute need for practicable, evidence-based solutions that address clinical negligence issues, and these should complement long-standing efforts to improve patient safety. Using 15 claim cases from one NHS Trust between 2004 and 2016, the quality of evidence informing claims was appraised using methods from evidence-based medicine. Most of the evidence informing clinical negligence claims was found to be the lowest quality possible (expert opinion). The extent to which the quality of evidence represents a normative deviance from scientific standards is discussed. To address concerns about the level of uncertainty involved in deriving quanta, we provide five recommendations for medico-legal stakeholders that are designed to reduce avoidable bias and correct potential market failures.

Wrongful pregnancy cases involve unwanted pregnancies and births caused by medical negligence. In all such cases, the resulting child is unplanned and the relevant healthcare professional’s services were retained in order to prevent pregnancy and childbirth. I argue that wrongful pregnancy victims are entitled to Total Recovery, damages for both child-rearing costs and losses associated with pregnancy. Critics of Total Recovery often appeal to the Offset/Benefits Approach (OBA). In its most radical form, OBA insists that healthy children always constitute an overall benefit to their parents and that this overall benefit cancels out any claim to damages for child-rearing costs. However, OBA cannot justify blocking or reducing wrongful pregnancy victims’ claims to child-rearing damages. The conviction that children must always be treated as overall beneficial to their parents is based on a confused combination of moralistic judgment and legal fiction. More importantly, the benefits of children, whatever these may be, fall outside the scope of the tortfeasor/victim relationship; these benefits are irrelevant to the assessment of damages. My case against OBA is based on an account of corrective justice that draws on the works of Ernest Weinrib and Arthur Ripstein. I illuminate both the defects of OBA and the justice of Total Recovery by comparing wrongful pregnancy suits with Weinrib’s famous plane crash example.

Aims: To compare and contrast how the law relating to medical negligence in England and Wales applies to conventional and complementary practice and to outline some of the legal issues which may arise. Methods: A thorough review of the literature was used to collect relevant information. This involved a comparative analysis of documentation, including Statutory Powers, Statutory Instruments, case law, books and journal publications. Results and discussion: Complementary therapists, regardless of whether they are private or NHS employees, are bound by the same duty of care for their patients as conventional practitioners and the same legal rules apply. If complementary therapists claim to possess special skills, then they are liable for actions arising out of clinical practice, in the same way as conventional practitioners. State registration, for the mainstream complementary therapies, is one way of improving the status of such professions as they become an integral part of the management of cancer patients. However, until they are fully integrated, a balance must be achieved so as to overcome any conflicts of interest between complementary and conventional healthcare practitioners and to facilitate acceptance of the former into the healthcare team. Conclusions: As complementary therapies are integrated into the care of cancer patients, controls and regulations must be implemented, possibly influenced by a legal framework, so as to establish a foundation for enhancing or adding authority to the ethical issues and guidelines which already exist.