The Role of Law in the Treatment Decisions of Doctors
The health system is complex. Regulating those who operate within it, however, is key to the effective promotion of the goals of the system. Regulating individuals can, in turn, be understood in terms of the regulation of their decisions. Julia Black’s ‘decentred regulation’, with her notion of the ‘ungovernable’ individual, is a step in the right path towards understanding the regulation of decisions, but it does not go far enough. With a discussion of the intersection of law and ideas from behavioural economics and psychology, this article explores the regulation of the health system in terms of the embedded decision-making of medical practitioners. The analysis will be rounded out with an assessment of four categories of decisions — conscientious objection, defensive medicine, decisions (properly seen as errors) that lead to patient harm and the prescription of ‘active placebos’.