The law uses the concept of decision-making capacity (or competence) to determine whether a person’s decision to, for example, refuse medical treatment, should be respected. If a person can express a decision, understand the relevant information, appreciate how it applies to his case, and use and weigh it in deliberation, then he has decision-making capacity, and the refusal should be respected as his to make, and otherwise not.
Can one person judge of another person whether she has decision-making capacity without prejudice? For example, can we judge whether a patient has decision-making capacity without resting on the fact that their preference not to be treated is not what we judge to be in their best interests, or not what we think we would have wanted had we been in their shoes? Why or why not?
Eligibility: Students and alumni of all University of London schools, including undergraduate and postgraduate, and medical and professional schools.
Length: less than 4,000 words
Due: 18 October 2017
Submission: Prepare your paper for blind review by making sure your name does not appear anywhere in the pages of the file, and send it to philandmed [at] kcl.ac.uk
Essays will be assessed by a panel of six distinguished academics from the University of London, chaired by Dr Tuomas Pernu.
The prize will be awarded at the Third Annual Sowerby Lecture in Philosophy and Medicine on 9 November 2017 which will be given by Dr Gareth Owen.
We are looking for a talented and committed solicitor to work predominantly within our Complex Patient Team which deals with disputes in some of the most complex and sensitive clinical scenarios.
The Team advises and represents the NHS in Wales in the Court of Protection which includes cases involving Serious Medical Treatment and Deprivation of Liberty. The Team also advises on Mental Health legislation and works closely with our Inquest team in cases involving death in detention.
This is a genuinely rare opportunity to join a team that works closely with its clients at the front line of clinical practice where legal and ethical problems are common.
You will be part of an experienced team that offers exciting opportunities not available elsewhere in Wales.
The ability to speak Welsh is desirable for this post
Closing date – 6th August 2017
For further details / informal visits contact:
Gavin Knox [KCL MA MEL alumnus]
Lecture: Mary Donnelly on Rebalancing Empowerment and Protection: Evolving Legal Frameworks for Impaired Capacity28 November 2016
Thursday 8 December 2016, 18:00 – 19:00
UCL Gustave Tuck Lecture Theatre, Wilkins Building, Gower Street, London WC1E 6BT
Current Legal Problems series
Speaker: Professor Mary Donnelly (University College Cork)
Accreditation: This event is accredited with 1 CPD hour with the SRA and BSB
Admission: Free, Registration required (here)
The past decade has seen a notable evolution in the normative context for law’s response to people with impaired capacity. Driven by a range of factors, including greater recognition of human rights (perhaps most notably through the Convention on the Rights of Persons with Disabilities) and better empirical understandings, a rhetoric of inclusion and empowerment has replaced traditional approaches centred on control and protection. Law reform projects in various jurisdictions (Australia, Canada, Ireland, Northern Ireland) have attempted to develop legislative frameworks to give effect to these emerging norms. Yet there is also another narrative. Concerns are expressed (perhaps most commonly by frontline professionals: healthcare professionals, lawyers, social workers and sometimes by family members of people with impaired capacity) that something important may be lost where there is a devaluation of protective norms. There is also a dissonance between the abstract ideals of human rights on the one hand and on the other, the complex corporeal, economic, family, phenomenological and social context within which people with impaired capacity, and those who care for/about them, live.
Tensions between empowerment and protection norms and between abstract, rights-based and contextual, evidence-based policy drivers are inevitable by-products of law’s evolution and they play a necessary role in the development of the law in this area. Rebalancing is a process and not a once-off event. And, of course, as revealed by even a minimal consideration of earlier legal responses to impaired capacity, there is a good deal of room for evolutionary wrong-turns and for unexpected and undesirable consequences. Placing current debates about how law should respond to impaired capacity within an evolutionary context, this paper identifies and evaluates the range of ways in which contemporary tensions may be resolved.
About the speaker:
Mary Donnelly is a Professor in the Law School, University College Cork. Her books include Consent: Bridging the Gap Between Doctor and Patient (Cork: Cork University Press, 2002); Healthcare Decision-Making and the Law: Autonomy, Capacity and the Limits of Liberalism (Cambridge: Cambridge University Press, 2010) and The Law of Credit and Security (Dublin: Round Hall Thomson Reuters, 2011; 2nd ed, 2015) and she is co-author of End-of-Life Care: Ethics and Law (Cork University Press, 2011) and Consumer Law: Rights and Regulation (Dublin: Round Hall Thomson Reuters, 2014) and co-editor of Ethical and Legal Debates in Irish Healthcare: Confronting Complexities (Manchester University Press, 2016).
She has collaborated on projects funded by the European Commission, the Irish Research Council for the Humanities and Social Sciences, the National Children’s Office and the Irish Hospice Foundation and has acted as consultant for public agencies and legal firms. She is/has been a member of the Expert Group to review the Mental Health Act 2001 and of the HSE National Consent Advisory Group and the HSE National Assisted Decision Making Steering Group.
Inside the Ethics Committee
From the programme’s website:
Monty has double pneumonia and is in intensive care. A ventilator is breathing for him and he’s sedated so that he can tolerate a breathing tube in his throat. Given the risks associated with being intubated in this way, the team are keen to get him off the ventilator as soon as possible, so that he can start breathing for himself.
After several days of antibiotics, Monty improves. So they stop the sedation, wake him up, and remove the breathing tube. The plan is for Monty to wear a mask to support his breathing until he is strong enough to breathe for himself.
But Monty is autistic, and as soon as the mask is placed on his face, he pushes it away. The nurses put it back on, but again he bats it off. The nurses persist, but Monty struggles and lashes out at them. Exhausted, he starts going blue. Fearing for Monty’s life, the team re-sedate him and put him back on the ventilator.
As his life hangs in the balance, what lengths should the medical team go to to get Monty to accept the life-saving treatment he is struggling against? Should they physically restrain him?
Joan Bakewell chairs the discussion between medical and ethical experts.