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AIM: The criteria for diagnosing abusive head trauma (AHT) are not well defined and this condition might be diagnosed on failing premises. Our aim was to review criminal AHT cases in Norwegian courts by scrutinising the underlying medical documentation. METHODS: Cases were identified in the data registry for Norwegian courts from 2004 to 2015. Documentation was obtained from relevant health institutions. The medical co-authors first made independent evaluations of the documentation for each child, followed by a consensus evaluation. RESULTS: A total of 17 children (11 boys) were identified, all diagnosed as AHT by court appointed experts, 15 were infants (mean age 2.6 months). A high proportion (41.2%) was born to immigrant parents and 31.3% were premature. The medical findings could be explained by alternative diagnoses in 16 of the 17 children; 8 boys (7 infants - mean age 2.9 months) had clinical and radiological characteristics compatible with external hydrocephalus complicated by chronic subdural haematoma. Six children (five infants with mean age 2.1 months) had a female preponderance and findings compatible with hypoxic ischaemic insults. CONCLUSION: The medical condition in most children had not necessarily been caused by shaking or direct impact, as was originally concluded by the court experts. Correction in: Acta Paediatrica, Vol. 111, Issue 4, pages 798-799DOI: 10.1111/apa.16268

Background Mechanical ventilation may relieve symptoms and prolong life for patients with amyotrophic lateral sclerosis, but may also prolong suffering. More knowledge is needed on ethical, legal and medical aspects upon termination. Material and methods Two cases are discussed in light of relevant laws and literature, as well as the authors' own research and clinical experience. Results A patient who had first declined life-sustaining treatment eventually chose to undergo tracheostomy. He later approached a locked-in state and wanted to terminate the treatment. Another patient reported poor quality of life and wanted to die, but declined to make a statement on refusal of resuscitation in case of an emergency. He was later resuscitated from CO2 narcosis and received non-invasive ventilation. He repeated that he wanted to die, but did not decide to terminate the ventilator until he was offered palliative treatment. Both patients received morphin and anxiolytics, and died shortly after the ventilator was withdrawn. Interpretation Mechanical ventilation can be terminated in line with good medical and ethical standards, and will then usually be legal. Patients have a legal right to refuse life-sustaining treatment, but not everybody want to make decisions regarding their own death. Fear of conducting euthanasia may prolong the patient's death process and prevent adequate palliative treatment.

Occasionally, an obstetrician can experience conflicts between the mother and her fetus. In a situation where the life of the fetus is in danger, religious, cultural, or other convictions may cause the mother to refuse the physician's recommendations for delivery. When there is a medical indication to perform cesarean section, but the mother refuses, has the obstetrician then a right to perform a cesarean section to save the fetus from possible death or serious injury? In 1987, The Norwegian Directorate of Health made a statement on cesarean section without consent, but later, new legislation on patient rights has been introduced. In Norway, no scientific medical articles have been published on this topic, and no cases have yet been brought to court. Cases of court-ordered cesarean section have been reported from the UK and the USA. In this report, we discuss some of the ethical, moral, and legal aspects of forced cesarean sections.

Summary The traditional concept of "informed" consent may be too restrictive; "valid" consent may be a more manageable criterion. Norway's 1999 Patients' Rights Act comes into force on Jan 1, 2001. This essay asks if this new legislation is compatible with this concept of valid consent—and concludes that it is.