Therapeutic jurisprudence, empirical ethics, and re-building (the) Trust

Activity: Talk or presentationInvited talkResearch


All women, birthing people and their families expect that they and their baby will be cared for safely and, where tragedies happen, that they will be well supported and treated with compassion. Over the last decade, a series of investigations into failures of NHS maternity services has made visible thousands of circumstances where this has not been the case. This is despite the fact that, since the report of the Morecambe Bay Investigation in 2015, maternity services have been the subject of more significant policy initiatives than any other NHS service. At the time of writing, a review into the quality and safety of maternity services at Nottingham University Hospitals NHS Trust is ongoing. Once again, the scope of the review includes oversight, governance and organisational culture. Further, on 18th August 2023, following the conviction of a nurse for murders and attempted murders of babies at Countess of Chester Hospital, an independent inquiry has been ordered, including into organisational governance processes which appeared to delay consideration of clinicians’ concerns. Clearly, what has been suggested before has not worked and, for the benefit of both the public and healthcare professionals, there is a significant, and urgent, need for change.
The most recent Inquiry to conclude, into services at East Kent Hospitals University NHS Foundation Trust (the East Kent Report), described failures of team working, of professionalism, of compassion, and failures to listen, concluding that the regulatory system was partially responsible for these values-based failures. The complex regulatory environment within which maternity services (and health services more generally) are provided has featured in previous inquiries, but the suggestion that the regulatory system is relevant to failures of compassion is new. Recent academic research has suggested something similar. For instance, the ASPIRE COVID-19 study, considering how to ensure safe, personalised routine care, concluded that the interpretation and application of law, regulation and governance are key. I want to propose an academic interrogation of the link between organisational legal processes and failures of compassion in health services, where ‘legal processes’ are broadly drawn, to include organisational engagement in the interpretation and application of laws, regulation and policy, and organisational governance and decision-making practices.
I am interested in whether legal processes designed specifically to underpin compassionate provision could improve health services. I have designed a study which proposes an innovative methodological approach, bringing together therapeutic jurisprudence (the study of law as a therapeutic agent) and empirical bioethics, to examine the role of legal processes in NHS hospitals, with a view to suggesting a new approach to health service regulation and policy. To my knowledge, therapeutic jurisprudence has not been explored in the NHS context, despite the existence of theoretical and empirical examples of its use in US health law and policy research.
Period18 Oct 2023
Event titleWINIR Workshop: Regulation and the Common Good
Event typeWorkshop
LocationSheffield, United KingdomShow on map
Degree of RecognitionInternational