Most patients in intensive care units lack mental capacity to inform decision-making, whether because of drugs or disease. The introduction of the Mental Capacity Act in England and Wales in 2005 has changed the way that doctors and institutions deal with patients who lack capacity. This is especially true when physical, mechanical or pharmacological restraints are used to allow the patient's treatment. Recently, the Supreme Court has ruled that if a person is under continuous supervision and control, and is not free to leave the place they are being treated, then they are deprived of their liberty. This article explains the ramification of this ruling for patients in intensive care whose care must now meet Deprivation of Liberties Standards. The procedures both for staff caring for these patients and for the Trusts where they are receiving care are described.

Clinicians and healthcare providers are frequently reminded that they are 'accountable' practitioners - but what is the definition of accountability, and how does it apply in a practical and legal context? To clarify these issues, the University of Nottingham School of Nursing has formed a partnership with Browne Jacobson Solicitors. Together they have developed a 7-stage training programme for nursing students which covers the key aspects of accountability, including ethical concepts, the law of negligence, and scenario-based training on being called as a witness in an investigation. This article introduces the implications of accountability and describes the structure and syllabus of the programme, including participants' feedback on the benefits of the experience.

This is the second of a three-part review of the development of case law on 'wrongful existence' claims. A previous article examined the increasing prominence of policy considerations in our jurisprudence more generally, often dressed as 'distributive justice', and considered the apparent trend toward preference for autonomy over more traditional views of the sanctity of life in recent years. This second article will describe the development of case law on 'wrongful existence' in some detail and will look briefly at the solutions in other jurisdictions. A third article will pick out the key elements of the leading authority (McFarlane, 1999), and ask whether any predictions can be made in this specific field or more widely.

potential disproportion between the level of fault and the amount of damages hints at this more subtly.Behind the McFarlane approach, there can be discerned an anxiety to protect precious NHS resources in the face of an increasing 'compensation culture'. Whether such a phenomenon exists is questionable, 5 but in many ways this is academic, since what is perceived to be real (whether by the judiciary, the legislature, or the underground commuter) inescapably has real effects. 6 Most tangible among these are the NHS

Purpose -This paper aims to review the recent Court of Protection case law on deprivation of liberty and consider whether it will help to achieve the right balance between minimising state interference with individuals and families, and protection of the most vulnerable, or risk undermining the core purpose of the system.Design/methodology/approach -The paper reviews the underlying rationale of the Deprivation of Liberty Safeguards (DOLS), the implications of the recent key Court of Appeal judgment in P v. Cheshire West and Chester.Findings -There are significant potential adverse effects from the judgment in Cheshire, and the way in which it has been interpreted to date, including a risk of undermining the very purpose of DOLS, and a risk of discriminatory effect.Originality/value -The paper provides a detailed analysis of Cheshire from the perspective of a Court of Protection practitioner, and advice on a practical approach to dealing with the concerns it raises.