Current DPhil in Medical Law: Q and A with Sarah Kilcoyne

Current DPhil in Medical Law: Sarah Kilcoyne

Why did you choose to do your DPhil at Oxford?

I originally moved to Oxford to work as a specialist Speech and Language Therapist at the John Radcliffe Hospital, working with patients with cleft palate, craniofacial conditions and facial palsy. I had previously completed a law degree, and a Masters of Laws (Health) in Australia. Whilst working as a Speech and Language Therapist, I began to notice that I had questions about the legal rights of young people with communication difficulties in the health care context. I applied to the University of Oxford because it was my local university, and I had met some DPhil students from Oxford and I was very impressed with their dynamic approach to research.

What is the title of your research and what is your research topic about? 

‘Decisions relating to plastic surgery to the head & face for children’

This research will examine children's participation in decision making about plans for their surgical treatment. Children in England regularly have head and neck surgery to repair damage due to accidents or burns, or to correct abnormalities they are born with (including cleft lip and palate or fused skull bones). However, as children grow, revision surgery may be offered, or requested, for aesthetic reasons.

It is common for these children to experience communication difficulties secondary to their underlying condition. For example, elevated rates of communication impairment have been identified in children with cleft palate and craniosynostosis, creating a potential obstacle for participation in decisions relating to their healthcare. For the majority of children having aesthetic surgery, their communication and cognitive development are age-appropriate, therefore they should be assessed to determine if they are competent to be involved in decision making. In terms of law and medical ethics, children’s communication difficulties should not normally be relevant to their assessment, nor inhibit their involvement in decision making.  However, this thesis will consider whether children with communication difficulties to experience obstacles to making decisions about plastic surgery, why that is, and how it can be overcome. 

This research will use interviews and observations to examine the experiences of children with, and without communication impairment, when making decisions relating to aesthetic surgery to the head and face. Experiences of parents and healthcare professionals will also be considered.

Who are your supervisors?

My supervisors are Professor Jonathan Herring, Dr Harriet Teare and Dr Teresa Finlay.

How did you think of your research topic?

My research topic came about from my experiences as a Speech and Language Therapist working with patients with cleft palate, craniofacial and facial palsy.

Does your work as a clinician help your research?

I work part-time as a frontline clinician in the NHS whilst doing the DPhil, and continue to conduct research to better understand the implications of specific diagnoses for patients’ speech, language, hearing, feeding and communication.

Where can people find more information about your work?

My most recent research can be found here:

Kilcoyne S, Rogers C, Thomas GPL, Wall S, Johnson D. Craniofacial Surgery-Related Hashtag Utilisation on Instagram. J Craniofac Surg. 2021 Mar 22. doi: 10.1097/SCS.0000000000007593. Epub ahead of print. PMID: 33770046.

Rajan, Sindhu Menon B. Speech Therapy (Hons)†; Dalton, Louise D Clin Psych∗; Judge, Andy PhD‡; Overton, Sarah MA, BSc (Hons)∗; Wall, Steven FCS(SA) Plast∗; Johnson, David MA, FRCS (Plast)∗ The Sensitivity and Specificity of Parental Report of Concern for Identifying Language Disorder in Children With Craniosynostosis, Journal of Craniofacial Surgery: January/February 2021 - Volume 32 - Issue 1 - p 36-41 doi: 10.1097/SCS.0000000000006840

Potter, Katherine Ruth MSc, MRCSLT∗; Gordon, Zoe BSc(Hons), MRCSLT†; Overton, Sarah BSc(Hons), MRCSLT∗; Brockbank, Sally BSc(Hons), MRCSLT∗; Jayamohan, Jayaratnam MBBSm, FRCS(SN)∗; Magdum, Shailendra FRCS∗; Smith, Martin MBBS, PhD§; Johnson, David MA, FRCS(Plast)∗; Wall, Steven FCS(SA) Plast∗; Wilkie, Andrew O.M. DM, FRCP∗,‡ Feeding, Communication, Hydrocephalus, and Intracranial Hypertension in Patients With Severe FGFR2-Associated Pfeiffer Syndrome, Journal of Craniofacial Surgery: January/February 2021 - Volume 32 - Issue 1 - p 134-140 doi: 10.1097/SCS.0000000000007153

Dupré, Sophie MBBS, BSc(Hons)∗,†; Care, Helen DClinPsy†; Gordon, Zoe BSc(Hons), MRCSLT‡; Wall, Steven A. FCS(SA) Plast†; Wilkie, Andrew O.M. DM FRCP†,§; Johnson, David MA, FRCS (Plast)†; Kilcoyne, Sarah BSpPath (Hons), MRCSLT† Implications for the Multi-Disciplinary Management of Children With Craniofrontonasal Syndrome, Journal of Craniofacial Surgery: June 2020 - Volume 31 - Issue 4 - p e362-e368 doi: 10.1097/SCS.0000000000006367

Kilcoyne S, Luscombe C, Scully P, Jayamohan J, Magdum S, Wall S, Johnson D, Wilkie A. Language Development, Hearing Loss, and Intracranial Hypertension in Children With TWIST1-Confirmed Saethre-Chotzen Syndrome. Journal of Craniofacial Surgery: February 20, 2019 - Volume Publish Ahead of Print.

Norris, J. Longmire N., Kilcoyne, S., Johnson, D., Fitzpatrick R., Klassen A.F. Exploring Patient Experience of Facial Nerve Palsy to Inform the Development of a PROM. Plastic and Reconstructive Surgery – Global Open: January 2019 - Volume 7 - Issue 1 - p e2072

Hotton M, Kilcoyne S, Holden C, Dalton L, Norris N, Johnson D. Addressing the physical and psychosocial needs of young people with facial palsy: facilitation of a single session group intervention. Journal of Plastic and Reconstructive Surgery (2019) in press

Kilcoyne, S. C.; Carrington, H., Walker-Smith, K., Morris, H., & Condon, C. (2014). Songs from the Outback: The Effectiveness of using Music in Treating Articulation Disorders in Children aged 2-5 years with Cleft Palate and Velopharyngeal Dysfunction. ASHA Perspectives: SIG 5, Speech Science and Orofacial Disorders, 24(2) 59-66.

Lewis, Fiona M., Coman, David J., Kilcoyne, Sarah, Murdoch, Bruce E. and Syrmis, Maryanne (2014) Pre-linguistic communication skill development in an infant with a diagnosis of galactosemia. Developmental Neurorehabilitation, 17 5: 291-297.

Lewis, Fiona M., Coman, David J., Syrmis, Maryann, Kilcoyne, Sarah and Murdoch, Bruce E. (2013) Charting a seven-year trajectory of language outcomes for a child with galactosemia. Journal of Developmental and Behavioral Pediatrics, 34 6: 414-418.

Lewis, F.; Coman, D.; Syrmis, M.; Kilcoyne, S; & Murdoch, B. (2013) Differential Phonological Awareness Skills in Children with Classic Galactosemia: A Descriptive Study of Four Children. JIMD Reports, 10: 45–52.

Lewis, Fiona M., Coman, David J., Syrmis, Maryanne, Kilcoyne, Sarah and Murdoch, Bruce E. (2012) Impaired language abilities and pre-linguistic communication skills in a child with a diagnosis of galactosaemia. Early Child Development and Care, 183 12: 1747-1757