AI Article Synopsis
- The movement against traditional ways of making medical decisions for patients who can't decide for themselves is growing, focusing on what patients would have wanted instead of just what's best for them.
- In England and Wales, a law called the Mental Capacity Act 2005 emphasizes the importance of patients’ past wishes and beliefs when making decisions about their care.
- A recent court case showed that while this approach tries to respect patients’ views, it might lead to problems like not considering the patients' actual medical needs and relying too much on what their caregivers think instead of what the patients might choose if they could.
Article Abstract
The modern legal and ethical movement against traditional welfare paternalism in medical decision-making extends to how decisions are made for patients lacking decisional capacity, prioritising surrogates' judgment about what patients would have decided over even their best interests. In England and Wales, the Mental Capacity Act 2005 follows this trend of prioritising the patient's prior wishes, values and beliefs but the dominant interpretation in life-sustaining treatment cases does so by in effect calling those values the 'best interests' of the patient and focusing nearly exclusively on the 'subjective' viewpoint of the patient. In this article, we examine the recent Court of Protection judgment in [2020] EWCOP 26, which adhered closely to this approach, to suggest that it could have unexpected negative consequences. These include insufficient information gathering about and attention to patients' objective medical interests, inadequacy of the evidentiary standard used for the substituted decision-making and, in some cases, even prioritising a surrogate's current substituted judgment over the potential for an actual judgment by the patient.
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| http://dx.doi.org/10.1136/medethics-2020-106797 | DOI Listing |
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