Criminal liability for fatal errors made by healthcare professionals, medical manslaughter (MM), has prompted much academic and professional debate. There is concern that doctors are increasingly vulnerable to this offence when they make inadvertent clinical errors in complex healthcare systems where mistakes are common and often arise from systemic causes. Yet, these discussions have been dominated by a few appellate court cases and focused on doctors, not victims. This highlights a key data gap and suggests that there may be patterns in MM cases not fully understood. This article analyses 192 MM cases that constitute all known investigations referred to the Crown Prosecution Service between 2007 and 2018. The analysis shows that MM prosecutions are extremely rare but also reveals previously unexplored trends, including high levels of individual advertent faults and deeper structural concerns beyond systemic faults. Although MM remains a contentious offence, attention must also shift to this wider body of cases, which demand approaches extending beyond criminal law and capable of addressing cross-cutting forms of culpability including structural violence. By situating these cases within a broader regulatory context, I demonstrate that MM cases constitute a vital yet underutilized resource for learning and accountability.

Aesthetic medicine is an extensively broad term for specialties that focus on improving cosmetic appearance through the treatment of conditions including scars, skin laxity, wrinkles, moles, liver spots, excess fat, cellulite, unwanted hair, skin discoloration, and spider veins. Traditionally, aesthetic medicine includes dermatology, oral and maxillofacial surgery, reconstructive surgery and plastic surgery. Aesthetic medicine includes both surgical procedures (liposuction, facelifts, breast implants, Radio frequency ablation) and non-surgical procedures (radio frequency skin tightening, non surgical liposuction, chemical peel, high-intensity focused electromagnetic field, radio frequency fat removal), and practitioners may utilize a combination of both. Although aesthetic medicine procedures are typically elective, they can significantly improve quality of life, psychological wellbeing and social engagement.

The market for cosmetic surgery tourism is growing with an increase in people travelling abroad for cosmetic surgery. While the reasons for seeking cosmetic surgery abroad may vary the most common reason is financial, but does cheaper surgery abroad carry greater risks? We explore the risks of poorly regulated cosmetic surgery to society generally before discussing how harm might be magnified in the context of cosmetic tourism, where the demand for cheaper surgery drives the market and makes surgery accessible for increasing numbers of people. This contributes to the normalisation of surgical enhancement, creating unhealthy cultural pressure to undergo invasive and risky procedures in the name of beauty. In addressing the harms of poorly regulated surgery, a number of organisations purport to provide a register of safe and ethical plastic surgeons, yet this arguably achieves little and in the absence of improved regulation the risks are likely to grow as the global market expands to meet demand. While the evidence suggests that global regulation is needed, the paper concludes that since a global regulatory response is unlikely, more robust domestic regulation may be the best approach. While domestic regulation may increase the drive towards foreign providers it may also have a symbolic effect which will reduce this drive by making people more aware of the dangers of surgery, both to society and individual physical wellbeing.

The Williams Review has emphasised the need for a clear and consistent understanding of what constitutes GNM. What does this look like in practice, and what impact will it have?

The criminal law looks set to play a larger role in regulating healthcare. Until recently, health professionals only faced the prospect of criminal liability if it could be proved that their gross negligence resulted in the death of a patient. In such a case, the professional could face a charge of gross negligence manslaughter (GNM). Prosecutions for ‘medical manslaughter’ have generated concern among doctors worried about what is perceived as a rise in the number of doctors facing criminal prosecution and the impact prosecutions are having on healthcare practice. May more frequent resort to the criminal process damage rather than promote better health care? In seeking to try to answer this question, the first problem is that reliable data in this area about how many prosecutions are brought and how they fare are limited due to the way cases are recorded. What evidence does exist is often based on media reports or samples that are not representative. This paper will argue that, while the real risk of bei...

Advances in medicine in the latter half of the twentieth century have dramatically altered human bodies, expanding choices around what we do with them and how they connect to other bodies. Nowhere is this more so than in the area of reproductive technologies (RTs). Reproductive medicine and the laws surrounding it in the UK have reconfigured traditional boundaries surrounding parenthood and the family. Yet culture and regulation surrounding RTs have combined to try to ensure that while traditional boundaries may be pushed, they are reconstructed in similar ways. This paper looks at the most recent RT to be permitted in the UK, mitochondria (mtDNA) replacement therapy (MRT). Despite controversial media headlines surrounding the technique, MRT is in fact an example of how science and regulation seek to expand models of traditional relatedness in a way that doesn’t challenge the existing order. Yet, like other RTs, while attempts are made to ensure it doesn’t push traditional boundaries too far, fissures and inconsistencies appear in law and culture, which give interesting insights into how genetics, parentage and identity are being mediated in new but familiar ways.

In recent years, debates have arisen concerning the encroachment of the criminal process in regulating fatal medical error, the implementation of the Corporate Manslaughter and Corporate Homicide Act 2007 and the recent release of the Director of Public Prosecution's assisted suicide policy. Consequently, questions have been raised regarding the extent to which such intervention helps, or if it in fact hinders, the sustained development of medical practice. In this collection, Danielle Griffiths and Andrew Sanders explore the operation of the criminal process in healthcare in the UK as well as in other jurisdictions, including the USA, Australia, New Zealand, France and the Netherlands. Using evidence from previous cases alongside empirical data, each essay engages the reader with the debate surrounding what the appropriate role of the criminal process in healthcare should be and aims to clarify and shape policy and legislation in this under-researched area.