2. Assisted dying: good medical practice, or murder?

2018 ◽  
pp. 11-26
Author(s):  
Michael Dunn ◽  
Tony Hope
Keyword(s):  
Medical Treatment ◽  
Medical Practice ◽  
Health Professionals ◽  
Patient Autonomy ◽  
Ethical Reasoning ◽  
Best Interests ◽  
Assisted Dying ◽  
Powerful Method ◽  
Good Medical Practice ◽  
Case Comparison

Euthanasia is one form of assisted dying. Other forms include assisting suicide and the withholding or withdrawing of life-extending medical treatment. The practice of euthanasia—killing a patient for the patient’s benefit—under some circumstances, is morally required by the two most widely regarded principles for guiding good medical practice: respect for patient autonomy and promoting patients’ best interests. ‘Assisted dying: good medical practice, or murder?’ considers four tools of ethical reasoning: defining terms, elucidating concepts, case comparison, and logic. It argues in favour of the law allowing health professionals, under certain conditions, to assist patients to die, and illustrates one common and powerful method of argument: countering the counter-arguments.

scholarly journals Perceptions of good medical practice in the NHS: a survey of senior health professionals

1999 ◽  
Vol 8 (4) ◽  
pp. 213-218 ◽  
Author(s):  
A. Hutchinson ◽  
M. Williams ◽  
K. Meadows ◽  
R. S. Barbour ◽  
R. Jones
Keyword(s):  
Medical Practice ◽  
Health Professionals ◽  
Good Medical Practice ◽  
Senior Health

Births by Caesarean section in the United States of America and in Britain

1980 ◽  
Vol 12 (3) ◽  
pp. 353-362 ◽  
Author(s):  
Colin Francome ◽  
Peter J. Huntingford
Keyword(s):  
United States ◽  
Caesarean Section ◽  
Medical Practice ◽  
United States Of America ◽  
The United States ◽  
Caesarian Section ◽  
Best Interests ◽  
Live Births ◽  
Good Medical Practice

SummaryThe rise in Caesarian section rates has been much greater in the United States than in Britain. This article analyses the reasons for these trends and finds they are not clearly related to good medical practice. It is concluded that it should be a cause for concern if rates rise above 6% of live births. In this case operations must be shown to be in the best interests of the mothers and their babies.

Causation in Criminal Law: A New Look at Jordan, Smith, Blaue and Cheshire

1998 ◽  
Vol 62 (5) ◽  
pp. 461-467
Author(s):  
Solomon E Salako
Keyword(s):  
Medical Treatment ◽  
Criminal Law ◽  
Medical Practice ◽  
Medical Science ◽  
Good Medical Practice ◽  
Judicial Attitudes ◽  
New Look

This article re-evaluates cases decided on legal causation in criminal law since Holland (1841) taking cognisance of advances in medical science, good medical practice and judicial attitudes. It is argued that Re T (1992) and Bland (1993) and cases sequel to them cast serious doubts on (and indeed compel a restatement of) the principles of legal attribution relating to intervening events and refusal of medical treatment.

The effect of the implementation of a good medical practice booklet on nursing home residents’ drug prescriptions: a difference-in-differences analysis based on data from electronic pill dispensers (Preprint)

2019 ◽  
Author(s):  
Stéphane Sanchez ◽  
Cécile Payet ◽  
Marie Herr ◽  
Anne Dazinieras ◽  
Caroline Blochet ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Medical Practice ◽  
Intervention Group ◽  
Medication Use ◽  
Nursing Home Residents ◽  
Control Group ◽  
Multilevel Regression ◽  
Difference In Differences ◽  
Good Medical Practice ◽  
The Impact

BACKGROUND The elderly are particularly exposed to adverse events from medication. Among the various strategies to reduce polypharmacy, educational approaches have shown promising results. OBJECTIVE We aimed to evaluate the impact of the implementation of a good medical practice booklet on polypharmacy in nursing homes. METHODS We identified nursing homes belonging to a geriatric care provider that had launched a policy of proper medication use using a good medical practice booklet delivered to prescribers and pharmacists. Data were derived from electronic pill dispensers. The effect of the intervention on polypharmacy was assessed with multilevel regression models, with a control group to account for natural trends over time. The main outcomes were the average daily number of times when medication was administered and the number of drugs with different presentation identifier codes per resident per month. RESULTS 96,216 residents from 519 nursing homes were included between 1 January 2011 and 31 December 2014. The intervention group and the control group both decreased their average daily use of medication (-0.05 and -0.06). The good medical practice booklet did not have a statistically significant effect (exponentiated difference-in-differences coefficient 1.00, 95% confidence interval 0.99-1.02, P=.45). CONCLUSIONS Although the good medical practice booklet itself did not seem effective in decreasing medication use, our data show the effectiveness of a higher-level policy to decrease polypharmacy.

Patient Autonomy, Capacity, and Consent

2020 ◽  
Author(s):  
Jessica Berg ◽  
Emma Cave
Keyword(s):  
Patient Autonomy ◽  
Medical Decision Making ◽  
The United States ◽  
Best Interests ◽  
Medical Decision ◽  
Human Rights Law ◽  
Federal Law ◽  
Medical Decisions ◽  
General Overview ◽  
Best Interests Standard

This chapter discusses patient autonomy, capacity, and consent involving children. It first provides a general overview of children’s rights with respect to making medical decisions in both the United States and Europe. The chapter then discusses the best interests standard (which is usually applied in cases of minors) and how to consider capacity in the context of children. In the discussions of European approaches, the chapter covers relevant international and regional human rights law. The jurisdiction of England and Wales are used as examples. The chapter also provides a general overview of US state approaches and federal law. The chapter concludes by noting some new areas of medical decision-making which challenge the traditional models.

Of Love and Laetrile: Medical Decision Making in a Child's Best Interests

1979 ◽  
Vol 5 (3) ◽  
pp. 269-294
Author(s):  
Eve T. Horwitz
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Burden Of Proof ◽  
State Intervention ◽  
Convincing Evidence ◽  
State Agency ◽  
Best Interests ◽  
Medical Decision ◽  
Appropriate Treatment ◽  
Life Threatening

AbstractTwo recent cases have raised important questions concerning the appropriateness of state intervention in parental choices of unorthodox medical treatment for children with life-threatening conditions. This Note first discusses whether, and if so, when, state intervention in a child's treatment selection by its parents is appropriate, and then analyzes the tests a court should apply in deciding upon an appropriate treatment. The Note recommends a decision-making approach that requires the appropriate state agency to prove, by clear and convincing evidence, that the parents' choice of medical treatment either is directly or is indirectly harming their child. Under this approach, if the state meets its burden of proof the court then must apply the ‘best interests’ test, rather than the ‘substituted judgment’ test, to choose an appropriate medical treatment for the child.

scholarly journals ‘Our legal responsibility…to intervene on behalf of the child’: Recognising public responsibilities for the medical treatment of children

2021 ◽  
Vol 21 (1) ◽  
pp. 19-41
Author(s):  
Jo Bridgeman
Keyword(s):  
Medical Treatment ◽  
Social Services ◽  
Local Authority ◽  
The State ◽  
Parental Authority ◽  
Best Interests ◽  
Legal Responsibility ◽  
Local Authorities ◽  
Professional Responsibilities ◽  
Seriously Ill

This article argues for recognition of public responsibilities to protect the welfare of children with respect to decisions affecting their health and medical treatment. As the quote in the title of this article, from David Plank, the Director of Social Services responsible for bringing the case of Baby Alexandra before the courts, identifies, early cases concerning children’s medical treatment were brought by local authorities to determine responsibilities to protect the welfare of children. In cases such as Re B (1981), Re J (1990) and Re W (1992), the court was asked not only to determine the child’s best interests but also to clarify the duties of the local authority, Trust, court and child’s parents to the child. The respective duties established apply to all involved in cases brought before the courts on the question of a child’s future medical treatment, whether or not the child is in the care of the state. Recent cases concerning the medical treatment of seriously ill children have involved claims of parental authority to determine the care of their child. To the contrary, this article argues that court involvement is required when parents are disagreed with the child’s treating doctors over the child’s medical treatment because of public as well as parental and professional responsibilities for the welfare of all children.

Medical treatment and best interests: judicial interpretation of values, wishes and beliefs under the Mental Capacity Act 2005

2020 ◽  
Vol 22 (3) ◽  
pp. 165-173
Author(s):  
Owen P. O'Sullivan
Keyword(s):  
Medical Treatment ◽  
Clinical Decision ◽  
Case Law ◽  
Decision Makers ◽  
Best Interests ◽  
Content Type ◽  
The Supreme Court ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act ◽  
The Uk

Purpose The prominence of the best interests principle in the Mental Capacity Act 2005 represented an important transition to a more resolutely patient-centred model regarding decision-making for incapable adults (“P”). This paper aims to examine the courts’ consideration of P’s values, wishes and beliefs in the context of medical treatment, reflect on whether this has resulted in a wide interpretation of the best interests standard and consider how this impacts clinical decision makers. Design/methodology/approach A particular focus will be on case law from the Court of Protection of England and Wales and the Supreme Court of the UK. Cases have been selected for discussion on the basis of the significance of their judgements for the field, the range of issues they illustrate and the extent of commentary and attention they have received in the literature. They are presented as a narrative review and are non-exhaustive. Findings With respect to values, wishes and beliefs, the best interests standard’s interpretation in the courts has been widely varied. Opposing tensions and thematic conflicts have emerged from this case law and were analysed from the perspective of the clinical decision maker. Originality/value This review illustrates the complexity and gravity of decisions of the clinical decision makers and the courts have considered in the context of best interests determinations for incapacitated adults undergoing medical treatment. Subsequent to the first such case before the Supreme Court of the UK, emerging case law trends relating to capacity legislation are considered.

scholarly journals Best interests: The ‘best’ way for courts to decide if young children should act as bone marrow donors?

2017 ◽  
Vol 17 (1-2) ◽  
pp. 3-42 ◽  
Author(s):  
Shih-Ning Then
Keyword(s):  
Bone Marrow ◽  
Young Children ◽  
Medical Practice ◽  
Best Interests ◽  
Potential Donor ◽  
Unique Position ◽  
Potential Child ◽  
The World ◽  
Psychological Harm ◽  
Continued Use

Young children who are called upon to donate regenerative tissue – most commonly bone marrow – to save the life of a sick relative are in a unique position. The harvest of tissue from them is non-therapeutic and carries the risk of physical and psychological harm. However, paediatric donation is relatively common medical practice around the world. Where some doubt exists over the legality of allowing a child to donate, courts can be asked to authorize the procedure and in doing so will apply the ‘best interests’ test in making their decision. How are a young child’s rights recognized in such a situation? This article considers whether the best interests test is the ‘best’ test to be applied by courts when cases of potential child donors come before it. The approach of courts in three jurisdictions is analysed, and problems in the application of the test in this context are discussed. While the continued use of the test by courts is supported, the way the test has been used by courts is critiqued and recommendations made to better respect the rights of the potential donor child.

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