From sperm to worm

Medical law is widely recognised as being one of the fastest moving and most exciting new areas of law. Each day, the media bombards us with stories of IVF and miracle babies, exciting new possibilities arising out of gene-mapping and the human genome project, the ever controversial subject of euthanasia and assisted suicide and, of course, the inevitable shroud-waving stories of children denied treatment on the NHS. Medical law is now firmly established as a discrete academic discipline, and most universities now offer it as an undergraduate subject, with several centres offering excellent masters and diplomas in healthcare law and ethics. Many faculties of medicine and nursing are also incorporating law and ethics into their curriculum.

Inevitably, this growth has been accompanied by a huge expansion in medical law literature, much of which is woefully disappointing. Not so the Medical Law Review. Since its launch in spring 1993, it would be fair to say that this impressive publication has established itself as the foremost journal in this rapidly advancing area.

Primarily, its success derives from the preeminence of its editors, Ian Kennedy and Andrew Grubb, both of the Centre of Medical Law and Ethics at King's College, London, and from the calibre of the articles commissioned. It also boasts a most prestigious editorial board.

Each issue contains three to five substantial articles. Mostly these are written by respected academics and, less commonly, by medical law practitioners. This part of the journal accounts for approximately a half to two thirds of the text. This is followed by a commentary section, case reports of important UK and international decisions. Occasionally, important parliamentary developments are also dealt with in this section. Periodically there is a book review section.

For the main part, the journal carries articles on the staples of medical law. The standard of the articles elevates the well-trodden subject matter into a higher realm. In an area of academic endeavour where much of the literature is bland and uninspiring, each edition of the Medical Law Review contains original, thought-provoking material.

From time to time more diverse subjects are included, such as Benjamin Andoh's paper on "The 'Right' to Retake Absconders from Mental Hospitals", Glanville Williams's "Controlling the Dangerous Offender" and Christopher Newdick's "Rights to NHS Resources after the 1990 Act". One suspects future volumes may have to expand the remit of the journal, so as to get in articles of a more political nature. It is only a matter of time before priority setting and the legal and ethical accountability of NHS managers will be as integral a part of medical law as the legal and moral status of the embryo, the distinction between active and passive euthanasia and the life expectancy of the "Bolam test" of medical negligence.

The academic articles alone would make the journal good value for money. Where the Medical Law Review comes into its own is the analysis offered in its commentary section. Unlike other series of medical law reports now available, the journal does not offer itself as a comprehensive case reporter. As an academic discipline, the joy of medical law is that it is a subject which is truly ground-breaking. Landmark decisions - such as the Bland case on withholding life-sustaining treatment; Re S, the first case of a forced Caesarean in the UK; and Re F on the sterilisation of a mentally handicapped adult woman are as much a reflection on contemporary society and the role and limits of lawmaking as it is possible to imagine. The past decade has witnessed legal decision making which goes to the very core of societal values. It is for this reason that the Medical Law Review does not trot out the usual litany of medical negligence cases. Rather, the cases dealt with in the commentary section are chosen for the way in which they extend or refine this fascinating area of law.

Each case report is followed by an analysis written either by Kennedy or Grubb. The firstrate analysis provided almost makes up for the fact that their well-known tome, Medical Law: Text with Materials is not a loose-leaf service. Unlike that work, which offer a frustratingly large number of sentences with question-marks, leaving the reader to decide how the court would decide a particular point, the analysis offered in the journal is both incisive and authoritative. In reviewing cases, Kennedy and Grubb set decisions not only in their legal context, but invariably in their political context as well, hinting at the future direction the law might take. To have such commentary on UK cases is invaluable, but to have a similar standard of excellence in relation to international case law is a veritable treat.

The Medical Law Review is primarily of interest to academics working in the field of healthcare law and ethics, and to students at both an undergraduate and post- graduate level. While not abstruse, this is a deeply academic legal journal, and some of the commentary might be slightly too legalistic for nonlawyer healthcare practitioners (unless they have had some training in medical law and ethics, as growing numbers have). The journal deserves to be widely read by legal practitioners specialising in medical law. The breadth of the subject matter also makes it readable for those interested in civil liberties, human rights and social policy, all of which form an integral part of the study of medical law.

It is increasingly recognised that modern health care no longer operates in a pyramidal, hierarchical structure, with orders being passed down from a paternalistic and patriarchal consultant. Rather, we are moving towards a multidisciplinary environment in which nurses, health visitors, professions like supplementary medicine and, increasingly, complementary practitioners, all have an important role to play. A journal which is so commendable in every other respect could arguably be more proactive in this regard, commissioning articles which reflect a broader basis of health care. Perhaps, therefore, it should be called Health Care Review or some such. However, this is but a minor criticism of an excellent journal.

Julie Stone is research associate, Hempsons Solicitors, and a lecturer in health care law and ethics.