Treatment in patients' best interests.

Lindsay Gee

doi:10.1080/17571472.2016.1225627

Abstract

A note on the current state of the law as regards balancing the autonomy, and personal values, of a mentally incapacitated patient against treatment plans with which they do not agree. The author summarises the outcomes of two medical treatment cases heard by the Court of Protection, with similar facts and different results, by way of adding to the advice to practitioners for their communications with patients and families in such situations.

Highlights

Why this matters to me Because the two cases together give a clear picture of the importance of weighing up the wishes, feelings, beliefs and values of a mentally incapacitated patient when deciding whether to give them treatment to which they object; and illustrate that their autonomy may override the need to give them treatment even if this may be a matter of life and death
Key message That you should not assume that the medical imperative of giving particular treatment, even life-saving treatment, to individuals will automatically outweigh their objections to it because they lack capacity to decide
Wide consultation is always desirable to help you ‘put yourself in the shoes’ of the patient from when they were in full health; while devising advance decisions, and other records of patients’ wishes and values, while they still have capacity will make such dilemmas relatively easier

Summary

Introduction

Why this matters to me Because the two cases together give a clear picture of the importance of weighing up the wishes, feelings, beliefs and values of a mentally incapacitated patient when deciding whether to give them treatment to which they object; and illustrate that their autonomy may override the need to give them treatment even if this may be a matter of life and death. Key message That you should not assume that the medical imperative of giving particular treatment, even life-saving treatment, to individuals will automatically outweigh their objections to it because they lack capacity to decide.

Results

Conclusion