The prescription of ‘unlicensed’ cannabis-based medicines was legalised in 2018. A ‘boundary work’ analysis of the post reform guidance issued for doctors reveals a discourse which frames the prescription of medicinal cannabis as a matter for clinical judgement, but also as fraught with medico-legal hazard. The article highlights a triad of rhetorical devices comprising the ‘last resort’ principle, ‘personal responsibility’ and the randomised controlled trial as an exclusive measure of ‘safety and efficacy’. Having identified a pronounced signalling of medico-legal risk which is likely to have a chilling effect on prescribing, this article explores how the Bolam-Bolitho formulation of the legal standard of care in negligence litigation might respond to this new domain of prescribing. This article concludes with observations about the compatibility of innovative prescribing of unlicensed cannabis medicines with the standard of care in negligence law, notwithstanding the extreme caution inherent in the interim prescribing guidance.

中文翻译：

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药用大麻处方：边界工作和医疗法律风险的研究

“无牌”大麻药物的处方于 2018 年合法化。 对为医生发布的改革后指导的“边界工作”分析揭示了一种话语，将药用大麻的处方作为临床判断的问题，但也令人担忧具有医疗法律风险。这篇文章强调了三重修辞手法，包括“最后手段”原则、“个人责任”和作为“安全性和有效性”的唯一衡量标准的随机对照试验。确定了可能对处方产生寒蝉效应的医疗法律风险的明显信号后，本文探讨了Bolam-Bolitho制定疏忽诉讼中的法律注意标准可能会回应这种新的处方领域。本文最后对未经许可的大麻药物的创新处方与疏忽法中的护理标准的兼容性进行了观察，尽管临时处方指南中固有的极其谨慎。