AVMA Improving healthcare through the use of ‘medical manslaughter’? Facts, fears and the future Margot Brazier 1 , Sarah Devaney 1 , Danielle Griffiths 2 , Alex Mullock 1 and Hannah Quirk 3 Abstract The criminal law looks set to play a larger role in regulating healthcare. Until recently, health professionals only faced the prospect of criminal liability if it could be proved that their gross negligence resulted in the death of a patient. In such a case, the professional could face a charge of gross negligence manslaughter (GNM). Prosecutions for ‘medical man- slaughter’ have generated concern among doctors worried about what is perceived as a rise in the number of doctors facing criminal prosecution and the impact prosecutions are having on healthcare practice. May more frequent resort to the criminal process damage rather than promote better health care? In seeking to try to answer this question, the first problem is that reliable data in this area about how many prosecutions are brought and how they fare are limited due to the way cases are recorded. What evidence does exist is often based on media reports or samples that are not representative. This paper will discuss that, while the real risk of being prosecuted for medical manslaughter remains low, such fears should not be dismissed because, as Donald Berwick has argued, ‘fear is toxic’ – for health professionals and their patients. Keywords Deaths in hospital, criminal law, healthcare law and ethics, health and the media Introduction Does the criminal law have any useful role to play in making healthcare safer? Oliver Quick is doubtful, and in the light of recent reports of healthcare scandals, he has asked whether yet more law and regulation can make any lasting impact to improving patient safety. 1 The Francis Reports of the events at Mid Staffordshire revealed disturbing evidence of abysmal care and neg- lect of vulnerable patients. 2 Such failures occurred des- pite the context of what Quick 3 describes as a ‘pluralistic regulatory landscape’ which should have protected patients. 4 In the aftermath of the publication of the Francis Report, a further inquiry led by Donald Berwick recommended the introduction of a much extended criminal offence of wilful neglect addressing the care of all patients in receipt of healthcare (as opposed to only mentally ill or mentally incapacitated patients as had previously been the case), 5 and there have been calls for the prosecution of health profes- sionals where serious neglect has caused patients serious injury. 6 The criminal law thus looks set to play a larger role in regulating healthcare. Berwick’s recommendations are intended to guide an NHS which reduces patient harm by placing an ethic of learning and improvement at its core. 7 A parallel intro- duction to the extension of the criminal sanctions avail- able in the medical setting was the duty of candour. 8 This statutory duty is placed on NHS organisations to be open about notifiable patient safety incidents which have or could result in significant harm (including death, severe or moderate harm or prolonged psycho- logical harm). These sit alongside existing professional duties stipulated by relevant professional bodies such as 1 Centre for Social Ethics and Policy, University of Manchester 2 School of Law, University of Sussex 3 Criminology University of Manchester Corresponding author: Danielle Griffiths, Freeman Building, Sussex Law School, University of Sussex, Brighton BN1 9QEV, UK. Email: danielle.griffiths@sussex.ac.uk Clinical Risk 0(0) 1–6 ! The Author(s) 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1356262217696623 journals.sagepub.com/home/cri