THE ROYAL IRISH ACADEMY IS IRELAND'S LEADING BODY OF EXPERTS IN THE SCIENCES AND HUMANITIES

Deirdre Madden MRIA: Professor of Law

26 January 2022

Professor Madden’s work is driven by the endless diversity and topicality of the issues that arise in the intersection of health law, medicine and ethics.

Deirdre Madden MRIA, Professor of Law, University College Cork

My research interests in medical/healthcare law and ethics really began in the second year of my undergraduate law degree in University College Cork when our lecturer told us about the first reported legal case being heard at that time involving commercial surrogacy in the UK. I was fascinated by the complexities of this arrangement, the conflicting constitutional, human rights, family law, contractual and even property law principles and public policies, the overriding paramountcy of the best interests of the child, and (rightly or wrongly) how law, politics, public morality and the media can shape the kinds of families there should be.

After graduation, I further developed this interest by pursuing a Master’s and later a PhD in assisted reproduction, surrogacy, reproductive genetics and the appropriate role of law in regulating behaviour in this most intimate and personal area of life. From there my interests broadened further to other areas of health law and ethics, including healthcare decision-making, end of life care, reproductive autonomy, professional regulation, patient safety, protection of personal health information and addressing health inequities.

I have always held the view that law is no more than a system of rules agreed and enforced by society and therefore it should always strive to be clear and understandable to everyone in society, written in plain English, as simple as possible and fair and proportionate in its intrusion into the lives of citizens. My interest in communication of the law in all its forms—its rationale, principles and values, its potential to shape and be shaped by political and public mores—ultimately made my decision to become an academic an easy one. My research has also led me to work on the practical application, implementation and communication of the law through the translation of legislation provisions and judicial decisions into policies, guidelines and codes of practice for professionals that are aimed at making comprehension and compliance easier.

One of the aspects of my work that I enjoy the most is the endless diversity and topicality of the issues that arise in the intersection of law, medicine and ethics. A reading of the newspapers on any day of the week will spark a new avenue for reflection, research and student engagement. I was deeply influenced in my early research by the author John Robertson, who is said to have put the field of law and bioethics on the law school map. Through the lens of his so-called ‘principle of procreative liberty’—meaning both the freedom to decide whether to have children as well as the freedom to control one’s reproductive capacity—Robertson captured my imagination. His analysis of the ethical, legal and social controversies in reproductive technology raised fascinating questions such as: Do frozen embryos have the right to be born? Should parents be allowed to select the sex and traits of their children? Should a government be able to force social welfare recipients to take contraceptives? These and many other socio-legal and ethical dilemmas have generated endless questions, multidisciplinary debates and policy proposals in this country and elsewhere about the beginning and ending of human life, the individual choices that societies are prepared to support, the overriding values of society that may compete with our respect for individual choices and how we decide as individuals and societies what really matters in the end.

Another area of huge interest for me is the role of law in patient safety, the discipline that aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care. How can the law influence, shape, control, regulate and support health care professionals and institutions in their efforts to keep people safe and provide them with the best possible care? We must recognise that healthcare is not a risk-free enterprise; as one of my favourite authors Atul Gawande (renowned surgeon, writer and public health leader in the US) puts it:

 ‘We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line.’

At the same time, we must also adhere to the principle that those who avail of healthcare services are entitled to expect to be treated by competent professionals who are appropriately skilled and up to date with developments in their field, in facilities that are fit for purpose and subject to regulatory oversight to ensure that appropriate standards are complied with. We are all entitled to be partners in our own healthcare, kept informed about our treatment and treated with honesty and respect if something goes wrong. I consider myself very fortunate that the balancing of all these values, rights and interests continues to both motivate and perplex me on a daily basis.

Read other Member Research Series articles.

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