Centre for Law, Medicine and Life Sciences (LML) Podcast · Faculty of Law, University of Cambridge

Medicine and the Rule of Law: The Baron Ver Heyden de Lancey Lecture 2024

·1 hr·5 clips

He reveals how a judge wrongly assumed children couldn't consent to puberty blockers without evidence.

This episode features the 2024 Baron de Lancy Lecture delivered by Professor Sir Jonathan Montgomery, a distinguished expert in health care law and bioethics, hosted by Professor Cathy Liddell of Cambridge's Centre for Law, Medicine and Life Sciences. Montgomery examines the complex relationship between medical practice and legal authority, specifically questioning the role of unelected judges in regulating doctors. He frames his talk as a plea for legal professionals to apply more rigorous discipline when engaging with medicine. Montgomery critiques the "Bolam test," a legal standard from the 1950s that often defers to medical profession norms in clinical negligence cases. He analyzes the "Bell and Tavistock" case concerning puberty-suppressing hormones, where a High Court judge made age-based assumptions about child consent capacity that the Court of Appeal later overturned. The lecture references controversies around the Tavistock Clinic, the subsequent Cass Review, and litigation involving figures like Keira Bell. Montgomery also explores end-of-life cases, citing Sir Ian Kennedy's critique that judicial "best interests" decisions in cases like Charlie Gard's may lack transparent legal principles. He details the Charlie Gard case, where cross-examination revealed an expert's proposed treatment had a "prospect of benefit of effectively zero." Another case involves Alfie Evans, where a German doctor allegedly entered a hospital covertly and provided a misleading statement to the court. Montgomery discusses the concept of "due process" as law's primary contribution, using the David Glass case to argue courts should create a fairer evidential playing field. He notes campaign groups like Christian Concern have criticized these judicial processes as exercising "absolute power." Former Supreme Court Justice Lord Sumption described the Charlie Gard ruling as a "nationalization of family life." Montgomery highlights resource imbalances in litigation, mentioning a well-resourced Jehovah's Witness lawyer who argues multiple international cases. He points to the Archie Battersbee case, which saw 11 court rulings in 18 weeks, and where the family felt video evidence was disregarded. The lecture traces assisted dying jurisprudence, from Diane Pretty's case in the House of Lords to the 2009 Debbie Purdy ruling and the later Nicklinson case, where the Supreme Court deferred to Parliament. Montgomery notes the Supreme Court later found Northern Ireland's abortion law a human rights breach, declaring courts "as well qualified to judge as the legislature" on abortion, but not on assisted dying. In the Conway case, the Supreme Court declined to hear an assisted dying appeal, calling the issue of "transcendent public importance" but unlikely to yield a useful outcome for the claimant. The tone is academic and reflective, grounded in legal analysis and case law. The style is a formal university lecture, methodically unpacking legal principles through specific historical examples. This episode would deeply interest law students, healthcare ethicists, and professionals working at the medicine-law intersection. Listeners seeking a broad cultural discussion or narrative storytelling might find the detailed legal examination too specialized.

As heard by us

A careful talk about how judges handle contested medical decisions.

Jonathan Montgomery's talk stays focused on the hard edge where medicine, family wishes, and the courts do not always line up. Using Charlie Gard as the central case, it shows how judges examine evidence, sort through facts, and decide when legal oversight is helpful rather than…

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If you want a Cambridge lecture on how judges decide when doctors have breached the law, start here.

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