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Systematically improving patient safety is of the utmost importance, but it is also an extremely complex and challenging task. This illuminating study evaluates the role of professionalism, regulation and law in seeking to improve safety, arguing that the 'medical dominance' model is ill-suited to this aim, which instead requires a patient-centred vision of professionalism. It brings together literatures on professions, regulation and trust, while examining the different legal mechanisms for responding to patient safety events. Oliver Quick includes an examination in areas of law which have received little attention in this context, such as health and safety law, and coronial law, and contends in particular that the active involvement of patients in their own treatment is fundamental to ensuring their safety.
In this final section we explore the relationship between behaviour which is regarded as violent by the formal processes of the criminal justice system (that is, police investigation, prosecution and trial), and that which is condoned or seen as appropriately controlled by other means. In Chapters 18 and 19 we consider different contexts in which violence occurs (at home, on the roads and in the workplace) and use them to demonstrate the ways in which the line between acceptable and unacceptable killing is socially constructed. We show that the criminal law definitions of unlawful homicide (murder, manslaughter and infanticide) cannot on their own explain the ways in which deaths are culturally understood as acceptable or not acceptable. At the same time, we seek to emphasise the argument that criminal regulation has an uneven and contested relationship with other forms of social control. We trace the history which explains how large corporations have tended to remain beyond the reach of criminal law and consider whether the Corporate Manslaughter and Corporate Homicide Act 2007 will significantly alter this.
Chapter 20 considers the boundary issues of homicide, and begins by questioning whether all killing is wrong. Medical practices in relation to the non-treatment of neonates (i.e. newly born infants), and the extent to which doctors can use pain-killing drugs to hasten death presents difficult questions at the margins of life and the margins of law.
The regulation of drugs and alcohol is instructive as an example of the legal response to, and construction of, a ‘social problem’. This particular ‘social problem’ periodically generates moral panics which result in, and rely upon, the representation of offenders as ‘dangerous’ and of the relevant activities as presenting a general threat to crime control and to ‘law and order’. A number of specific questions can be raised about the criminal regulation of drugs and alcohol. Notable among these are the uneven ‘mens rea’ requirements under the Misuse of Drugs Act 1971, and in particular the arbitrary distinction between alcohol and other drugs. This division is especially contestable given the facts that alcohol has greater addictive qualities than some of the proscribed drugs under the Misuse of Drugs Act 1971, and is arguably more strongly associated with health and social problems in the UK than is, for example, cannabis (Husak 2002). While the possession of both alcohol and tobacco is generally lawful, their use is highly regulated in terms of those to whom they can be sold and where they can be consumed.
There are many specific offences associated with alcohol and drug use. While alcohol is lawfully available but regulated, the possession of many drugs is prohibited. A large number of people come into the criminal justice system through alcohol-specific offences, for example being drunk and disorderly in public, and offences against the licensing laws, such as selling or serving alcohol to underage drinkers.