By Ken Thomas, medical negligence specialist at Harding Evans.

The tragic case of Welsh baby Luke Winston Jones has rarely been out of the headlines over the last month or so. Sadly, baby Luke died last week aged 10 months – he had never left hospital during his short life.

Luke’s care became the subject of a Court case when there was disagreement between his family and treating doctors over what was best for the child. Eventually, a High Court Judge ruled that doctors could withhold treatment if the baby’s condition worsened. Luke’s family had disagreed with medical advice offered – they felt the decision should be up to them. They had argued that although their son was desperately ill, children with his severe chromosome abnormality could live for many years.

This was not the first such case. Only a few months back, the High Court had to consider the case of Charlotte Wyatt where again doctors and family disagreed. The clinicians wanted permission from the Court not to resuscitate the baby girl as her quality of life would, in any event, be so poor. There again the High Court backed the doctors.

Disability pressure groups have said they hope that these two cases will not be used as precedents too readily. In most cases, of course, the doctors and families will agree. The families of Luke and Charlotte together with the treating doctors, agreed to these cases being held in open Court on the basis that it was in the public interest.

The question of treatment ethics is one that has come to the fore for some years. Indeed, the issue of medical ethics and its relationship with the law is now a subject in itself studied by law and medicine students alike.

Such issues arise to a degree from evolving medical advances, which mean that very poorly babies, especially those who are born prematurely, can now survive when in years gone by they may not have done.

Difficult ethical decisions arise in other areas of medical care. Euthanasia – that is, assisted death, continues to create all sorts of conflicts. Some have called for euthanasia to be legalised. Back in the 1980’s a Dutch Court ruled that voluntary euthanasia could be acceptable. In this country it remains against the law. In truth, how many people are helped to die is far from clear.

Few could forget the bravery of Diane Pretty who suffered from Motor Neurone Disease and took her case to Court. Diane died in May 2002. She had lost a legal battle to allow her husband to help her commit suicide. We can be sure that such issues will fall for determination by Courts again in the future.

The recent Nationwide Organ Retention Litigation has also turned to a large degree on a question of ethics and the rights and wrongs of medical practice in retention of tissue samples, organs, etc. As we know, some families here in Gwent became involved in these cases.

Advances in reproductive medicine have thrown up concerns regarding cloning, not to mention the right to use retained semen after the death of a partner or husband. That issue was of course considered and reported the world over in the case of Diane Blood. Mr Blood had contracted meningitis – the couple had been trying for a child at the time. Sperm had therefore been extracted and stored but after Mr Blood’s sudden death, the authorities declined to allow his widow to undergo treatment. Her husband had not given written consent. Diane Blood lost her case in the High Court but an Appeal Court said that her legal right to medical treatment in Europe had to be recognised. She was therefore allowed to export the sperm abroad and she has now had 2 children after IVF treatment in Belgium. One poll suggested 90% of people had been in favour of her being allowed to have her dead husband’s children.

Closer to home, the Assembly Health Minister receives advice on issues relating to medical ethics. One thing is for sure, such major questions of ethics will continue to occupy the minds of legal and medical professionals for many years to come.