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HOW MUCH DO YOU DRINK?
408 The
judge believed that had the plaintiff been told of the
comparative
failure
and that her husband could have a as an vasectomy outpatient, she would not have agreed to be sterilised and that her husband would have been vasectomised. Accordingly, the defendants had failed to comply with medical standards and were negligent in not informing the plaintiff of the failure rate of female sterilisations and that this negligence resulted in the plaintiff being sterilised. rates
operation might not succeed in its aim and to mention other methods of contraception. There was no reason for failing to mention such matters. Damages of 19 000 were awarded in respect of the birth of the fourth child. An appeal is to be lodged. Gold v Haringey Health Authority.
A Second Action A
Different Legal Test Imposed for Contraceptive Counselling
judge also based his decision on a novel point, in which he distinguished the present case which was concerned with contraceptive counselling and practice from one where female sterilisation was necessary on therapeutic grounds. He said that although he had made a distinction in his findings as to the medical practice between therapeutic and contraceptive contexts, it was fair to say the evidence was not "crystal clear" on this point. Thus, it was The
also necessary to consider whether he would still have found the defendants negligent if he had been satisfied that there was a responsible body of medical opinion which in a contraceptive and counselling context would have acted toward the plaintiff as the defendants’ hospital doctors had done. For this purpose, the judge said he was not bound by the usual clinical judgment test imposed by the House of Lords in the cases of Sidaway and of Bolam, because here the court was not essentially concerned with the doctrine of informed consent. Therefore, as a matter of law, Mr Justice Schiemann said he was free to hold that the questions whether or not vasectomy should be mentioned as an option, whether or not the person giving advice should mention that there was a risk that female sterilisation operation would not achieve the desired result, and whether or not the relative risks of vasectomy and female sterilisation should be disclosed was not to be determined exclusively by the current state of responsible and competent professional opinion and practice at the time, though both were of course relevant considerations. The judge maintained that the hospital doctors, faced with a perfectly normal sensible woman with no particular psychiatric, social, or medical problems were under a duty to mention that the
Notes and News
Schiemann J. QBD. June 16,1986.
Arising from Failed Sterilisation
On July 2, 1986, in Jones v Berkshire Health Authority, Mr Justice Ognall in the High Court awarded £ 39 963 in damages to a former psychiatric nurse, following the birth of a healthy daughter by caesarian section. The plaintiff had not been warned of the 1/300 risk that she might become pregnant again after sterilisation, which was competently performed in July, 1977. The plaintiff already had two
children when she discovered she
was
7 months’ pregnant.
Accordingly, it was too late for an abortion which her obesity, back trouble, and high blood pressure made advisable. The judge said that because it did not occur to the plaintiff that she might be pregnant, for weeks she seriously thought she might have cancer of the womb and this caused her a good deal of anguish. She was awarded 2750 for pain and suffering during pregnancy and caesarian section. The bulk of the damages were to compensate the plaintiff for loss of earnings as a community worker and for the cost of rearing the child. The judge said, however, that it was a matter of surprise to him that the law acknowledged an entitlement for a mother to claim damages for a healthy child.. "it is certain that those afflicted with a handicapped child or who are denied the blessing of a child will regard this with astonishment". A conflict of evidence had arisen when the health authority claimed that the plaintiff had been warned of the possibility of failure of the sterilisation on three different occasions by three different doctors. However, the judge found that "a conveyor belt" system had operated at the clinic and each patient had only 6 minutes with the doctor. The system whereby patients were warned of the possible failure of sterilisation had now been revised. DIANA BRAHAMS, Barrister-at-law
forging of strong links between the different agencies of care and the development of "key workers" to ensure that every mentally handicapped person and family has direct access to an informed and responsible worker aware of local services and initiatives.
CARE IN THE COMMUNITY: MENTAL HANDICAP A RECENT report’ from the Office of Health Economics condemns the disappointly slow rate of development in improving services for the mentally handicapped as "a deficiency of political will". The number of people in NHS mental handicap hospitals and units has fallen from 60 000 to less than 40 000 in England since the beginning of the ’70s and the number of mentally handicapped children in these facilities has fallen by 80% over the same period. Few NHS mental handicap hospitals have, however, been closed. In general they have been reduced in size while the total number of hospitals and units has actually increased. In other words, the savings resulting from a falling inpatient population have been limited. The report notes that the percentage of total hospital resources allocated to mental handicap has remained contant at around 6% since 1970. In contrast, local authority spending on services for the mentally handicapped has risen by 150% over the same period. Community services have tended to evolve piecemeal, without regard for the needs and wishes of individuals, families, professionals, and the statutory and voluntary agencies. The way forward, declare the authors of the report, requires tailored support for the needs of each individual, support that demands close coordination between education, housing, and employment authorities, social services, and the voluntary sector. The key restraint to the provision of better local services is financial, although there is little evidence for claims that institutionalised mentally handicapped adults have been thrown out into the streets. Mental Handicap-Close Partnership in the Community? urges the Handicap-Partnership in the Community? By Jean Taylor and David Taylor. Published by the Office of Health Economics and Mencap. Available (£1.50) from OHE, 12 Whitehall, SW1A 2DY.
1. Mental
HOW MUCH DO YOU DRINK?
JUST over half of the people interviewed in a survey’ carried out by the Health Education Council believe that moderate drinking is good for health. 3304 people were asked to examine how they regarded alcohol and its effects. The survey was not intended to find out how much alcohol people actually drink, but what people believe about alcohol consumption-their own and other people’s. 9 out of 10 adults in England and Wales are at least occasional drinkers, men are more likely to be "heavier" drinkers than women, and young people are more likely to be "heavier" drinkers than older people. Many people think that alcohol consumption has increased in recent years, particularly in young people, but a large majority of people describe their own drinking as lessening over the years. So it appears that many people drink in considerable quantity when they start drinking but moderate their habit over the years. This pattern does not affect an overall increase in total consumption of alcohol, particularly since people appear to be starting to drink at a younger age. Unfortunately, many people still believe that beer is a more dilute form of alcohol than it is-spirit and wine drinkers, on average, appear to take in just over half the amount of alcohol as beer drinkers. Only one person in 20 said that they drank more than a "moderate amount" and only 7 % admitted to getting even slightly drunk as often as once a month. The only action to prevent excessive consumption of alcohol favoured by almost everyone was a ban on alcohol
at
football’ matches. Increases in
tax or a
ban
on
alcohol
advertising on television were unpopular, although nearly half of the respondents thought that alcohol was on sale in too many shops. 1. Beliefs about Alcohol.
By Douglas Wood. Health
Education
Council,
1986
judge believed that had the plaintiff been told of the
comparative
failure
and that her husband could have a as an vasectomy outpatient, she would not have agreed to be sterilised and that her husband would have been vasectomised. Accordingly, the defendants had failed to comply with medical standards and were negligent in not informing the plaintiff of the failure rate of female sterilisations and that this negligence resulted in the plaintiff being sterilised. rates
operation might not succeed in its aim and to mention other methods of contraception. There was no reason for failing to mention such matters. Damages of 19 000 were awarded in respect of the birth of the fourth child. An appeal is to be lodged. Gold v Haringey Health Authority.
A Second Action A
Different Legal Test Imposed for Contraceptive Counselling
judge also based his decision on a novel point, in which he distinguished the present case which was concerned with contraceptive counselling and practice from one where female sterilisation was necessary on therapeutic grounds. He said that although he had made a distinction in his findings as to the medical practice between therapeutic and contraceptive contexts, it was fair to say the evidence was not "crystal clear" on this point. Thus, it was The
also necessary to consider whether he would still have found the defendants negligent if he had been satisfied that there was a responsible body of medical opinion which in a contraceptive and counselling context would have acted toward the plaintiff as the defendants’ hospital doctors had done. For this purpose, the judge said he was not bound by the usual clinical judgment test imposed by the House of Lords in the cases of Sidaway and of Bolam, because here the court was not essentially concerned with the doctrine of informed consent. Therefore, as a matter of law, Mr Justice Schiemann said he was free to hold that the questions whether or not vasectomy should be mentioned as an option, whether or not the person giving advice should mention that there was a risk that female sterilisation operation would not achieve the desired result, and whether or not the relative risks of vasectomy and female sterilisation should be disclosed was not to be determined exclusively by the current state of responsible and competent professional opinion and practice at the time, though both were of course relevant considerations. The judge maintained that the hospital doctors, faced with a perfectly normal sensible woman with no particular psychiatric, social, or medical problems were under a duty to mention that the
Notes and News
Schiemann J. QBD. June 16,1986.
Arising from Failed Sterilisation
On July 2, 1986, in Jones v Berkshire Health Authority, Mr Justice Ognall in the High Court awarded £ 39 963 in damages to a former psychiatric nurse, following the birth of a healthy daughter by caesarian section. The plaintiff had not been warned of the 1/300 risk that she might become pregnant again after sterilisation, which was competently performed in July, 1977. The plaintiff already had two
children when she discovered she
was
7 months’ pregnant.
Accordingly, it was too late for an abortion which her obesity, back trouble, and high blood pressure made advisable. The judge said that because it did not occur to the plaintiff that she might be pregnant, for weeks she seriously thought she might have cancer of the womb and this caused her a good deal of anguish. She was awarded 2750 for pain and suffering during pregnancy and caesarian section. The bulk of the damages were to compensate the plaintiff for loss of earnings as a community worker and for the cost of rearing the child. The judge said, however, that it was a matter of surprise to him that the law acknowledged an entitlement for a mother to claim damages for a healthy child.. "it is certain that those afflicted with a handicapped child or who are denied the blessing of a child will regard this with astonishment". A conflict of evidence had arisen when the health authority claimed that the plaintiff had been warned of the possibility of failure of the sterilisation on three different occasions by three different doctors. However, the judge found that "a conveyor belt" system had operated at the clinic and each patient had only 6 minutes with the doctor. The system whereby patients were warned of the possible failure of sterilisation had now been revised. DIANA BRAHAMS, Barrister-at-law
forging of strong links between the different agencies of care and the development of "key workers" to ensure that every mentally handicapped person and family has direct access to an informed and responsible worker aware of local services and initiatives.
CARE IN THE COMMUNITY: MENTAL HANDICAP A RECENT report’ from the Office of Health Economics condemns the disappointly slow rate of development in improving services for the mentally handicapped as "a deficiency of political will". The number of people in NHS mental handicap hospitals and units has fallen from 60 000 to less than 40 000 in England since the beginning of the ’70s and the number of mentally handicapped children in these facilities has fallen by 80% over the same period. Few NHS mental handicap hospitals have, however, been closed. In general they have been reduced in size while the total number of hospitals and units has actually increased. In other words, the savings resulting from a falling inpatient population have been limited. The report notes that the percentage of total hospital resources allocated to mental handicap has remained contant at around 6% since 1970. In contrast, local authority spending on services for the mentally handicapped has risen by 150% over the same period. Community services have tended to evolve piecemeal, without regard for the needs and wishes of individuals, families, professionals, and the statutory and voluntary agencies. The way forward, declare the authors of the report, requires tailored support for the needs of each individual, support that demands close coordination between education, housing, and employment authorities, social services, and the voluntary sector. The key restraint to the provision of better local services is financial, although there is little evidence for claims that institutionalised mentally handicapped adults have been thrown out into the streets. Mental Handicap-Close Partnership in the Community? urges the Handicap-Partnership in the Community? By Jean Taylor and David Taylor. Published by the Office of Health Economics and Mencap. Available (£1.50) from OHE, 12 Whitehall, SW1A 2DY.
1. Mental
HOW MUCH DO YOU DRINK?
JUST over half of the people interviewed in a survey’ carried out by the Health Education Council believe that moderate drinking is good for health. 3304 people were asked to examine how they regarded alcohol and its effects. The survey was not intended to find out how much alcohol people actually drink, but what people believe about alcohol consumption-their own and other people’s. 9 out of 10 adults in England and Wales are at least occasional drinkers, men are more likely to be "heavier" drinkers than women, and young people are more likely to be "heavier" drinkers than older people. Many people think that alcohol consumption has increased in recent years, particularly in young people, but a large majority of people describe their own drinking as lessening over the years. So it appears that many people drink in considerable quantity when they start drinking but moderate their habit over the years. This pattern does not affect an overall increase in total consumption of alcohol, particularly since people appear to be starting to drink at a younger age. Unfortunately, many people still believe that beer is a more dilute form of alcohol than it is-spirit and wine drinkers, on average, appear to take in just over half the amount of alcohol as beer drinkers. Only one person in 20 said that they drank more than a "moderate amount" and only 7 % admitted to getting even slightly drunk as often as once a month. The only action to prevent excessive consumption of alcohol favoured by almost everyone was a ban on alcohol
at
football’ matches. Increases in
tax or a
ban
on
alcohol
advertising on television were unpopular, although nearly half of the respondents thought that alcohol was on sale in too many shops. 1. Beliefs about Alcohol.
By Douglas Wood. Health
Education
Council,
1986