Price D
Social Welfare Research Unit, University of Northumbria at Newcastle, Newcastle upon Tyne.
BMJ. 1996 Jan 20;312(7024):167-9. doi: 10.1136/bmj.312.7024.167.
More details have emerged about the child B leukaemia case with the publication of the All England Law Report on the Appeal Court decision. At the time the view was widely held that the controversy might have been avoided if the responsible health authority had consulted the public. The law report reveals, however, that the courts adopted a moral language widely at variance with that of the patient's doctor. The courts were concerned to support a utilitarian decision procedure based on calculations of the greatest overall good; the doctor was concerned with the best interests of a sick child. The doctor-patient relationship may be damaged when public consideration transforms the issue in this way. Also, the Appeal Court supported a decision which claimed to have "weighed" opposing evaluations, but it excused the health authority from describing how that weighing took place. One of the main criticisms of the utilitarian approach, however, is that weighing of this type is extremely difficult to justify. By its ruling the court has made legal challenge on the grounds of inadequate consultation virtually impossible to substantiate.
随着《全英法律报告》公布上诉法院的判决结果，儿童B白血病病例的更多细节浮出水面。当时人们普遍认为，如果负责的卫生当局咨询公众，这场争议或许可以避免。然而，法律报告显示，法院采用的道德语言与患儿医生的语言大相径庭。法院关注的是支持一种基于总体最大利益计算的功利主义决策程序；而医生关注的是患病儿童的最佳利益。当公众考量以这种方式改变问题时，医患关系可能会受到损害。此外，上诉法院支持了一项声称已“权衡”了对立评估的决定，但却免除了卫生当局描述这种权衡是如何进行的责任。然而，对功利主义方法的主要批评之一是，这种权衡极难自圆其说。根据法院的裁决，以咨询不足为由进行法律质疑几乎不可能得到证实。
