Towards improved understandings of medical manslaughter: fatal medical error, accountability, and wider paths to learning.

Criminal liability for fatal errors made by healthcare professionals, medical manslaughter (MM), has prompted much academic and professional debate. There is concern that doctors are increasingly vulnerable to this offence when they make inadvertent clinical errors in complex healthcare systems where mistakes are common and often arise from systemic causes. Yet, these discussions have been dominated by a few appellate court cases and focused on doctors, not victims. This highlights a key data gap and suggests that there may be patterns in MM cases not fully understood. This article analyses 192 MM cases that constitute all known investigations referred to the Crown Prosecution Service between 2007 and 2018. The analysis shows that MM prosecutions are extremely rare but also reveals previously unexplored trends, including high levels of individual advertent faults and deeper structural concerns beyond systemic faults. Although MM remains a contentious offence, attention must also shift to this wider body of cases, which demand approaches extending beyond criminal law and capable of addressing cross-cutting forms of culpability including structural violence. By situating these cases within a broader regulatory context, I demonstrate that MM cases constitute a vital yet underutilized resource for learning and accountability.