Barnsley Hospitals NHS Foundation Trust v MSP [2020] EWCOP 26: The Need for Caution When Establishing the Wishes of Incapacitated Patients

2021 ◽  
Author(s):  
Cressida Auckland
Keyword(s):  
Incapacitated Patients

Legal Regulation of Treatment for Depression

2017 ◽  
Author(s):  
Hugh Series
Keyword(s):  
Legal Regulation ◽  
Mental Capacity ◽  
Medicinal Products ◽  
Over The Counter ◽  
Controlled Drugs ◽  
Treatment Of Depression ◽  
Mental Capacity Act 2005 ◽  
Incapacitated Patients ◽  
Mental Capacity Act ◽  
Over The Counter Medicines

This chapter reviews the legal regulation of treatment of depression as it exists in England and Wales, where medicinal products are regulated largely by the Medicines Act 1988 and the Misuse of Drugs Act 1971. The Medicines Act divides medicinal products into pharmacy only medicines, which can only be purchased under the supervision of a pharmacist, over-the-counter medicines, and prescription only medicines. The Misuse of Drugs Act is concerned with controlled drugs. These are divided into three classes according to their perceived degree of harmfulness. This chapter considers treatment with valid consent and two pieces of legislation that govern people who are sufficiently ill and need to be admitted to hospital: the Mental Health Act 1983 (MHA) and the Mental Capacity Act 2005 (MCA). It also discusses treatment of mentally incapacitated patients and the issue of liberty regarding the admission of a compliant but incapacitated patient to hospital. Finally, it looks at three types of non-medical prescribing in England, issued by independent prescribers, supplementary prescribers, and community practitioners.

Trial by Triad: substituted judgment, mental illness and the right to die

2021 ◽  
pp. medethics-2020-107154
Author(s):  
Jacob M Appel
Keyword(s):  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Substituted Judgment ◽  
Diminished Capacity ◽  
Accepted Standard ◽  
The Usa ◽  
Aid In Dying ◽  
Incapacitated Patients ◽  
The Right

Substituted judgment has increasingly become the accepted standard for rendering decisions for incapacitated adults in the USA. A broad exception exists with regard to patients with diminished capacity secondary to depressive disorders, as such patients’ previous wishes are generally not honoured when seeking to turn down life-preserving care or pursue aid-in-dying. The result is that physicians often force involuntary treatment on patients with poor medical prognoses and/or low quality of life (PMP/LQL) as a result of their depressive symptoms when similarly situated incapacitated patients without such depressive symptoms would have their previous wishes honoured via substituted judgment. This commentary argues for reconsidering this approach and for using a substituted judgment standard for a subset of EMP/LQL patients seeking death.

We Should Widen Access to Physician-Assisted Death

2021 ◽  
pp. 1-31
Author(s):  
Jordan MacKenzie ◽  
Adam Lerner
Keyword(s):  
Advance Directives ◽  
Terminally Ill ◽  
Decision Makers ◽  
Assisted Death ◽  
Surrogate Decision Makers ◽  
Incapacitated Patients ◽  
Surrogate Decision ◽  
Rule Out

Abstract Typical philosophical discussions of physician-assisted death (“pad”) have focused on whether the practice can be permissible. We address a different question: assuming that pad can be morally permissible, how far does that permission extend? We will argue that granting requests for pad may be permissible even when the pad recipient can no longer speak for themselves. In particular, we argue against the ‘competency requirement’ that constrains pad-eligibility to presently-competent patients in most countries that have legalized pad. We think pad on terminally ill, incapacitated patients can be morally permissible in cases where advance directives or suitable surrogate decision-makers are available, and should be legally permissible in such cases as well. We argue that this view should be accepted on pain of inconsistency: by allowing surrogate decision-makers to request withdrawal of life-sustaining care on behalf of patients and by allowing patients to request pad, we rule out any plausible justification for imposing a competency requirement on pad.

scholarly journals Old age psychiatry and the law

2002 ◽  
Vol 180 (2) ◽  
pp. 116-119 ◽  
Author(s):  
Robin Jacoby
Keyword(s):  
Human Rights ◽  
Old Age ◽  
Case Law ◽  
European Convention ◽  
The Status ◽  
Human Rights Act ◽  
Old Age Psychiatry ◽  
Human Rights Act 1998 ◽  
Incapacitated Patients ◽  
Do So

BackgroundOld age psychiatry is no less subject to increasing legal and quasi-legal restraint than other branches of the profession, but the emphases are different. Two themes predominate: first, that of capacity or competence; and second, to what extent formal legal measures should be implemented in cases where incapacitated patients do not dissent from, as opposed to giving active consent to, admission to hospital or receiving treatment.AimsTo discuss the issues of capacity or competence, especially in relation to recent legislation and judgements and to proposed legislation in England and Wales.MethodSelective review and discussion of recent case law and current and proposed statute law.Results and conclusionsThe Bournewood case threatened but ultimately failed to upset the status quo. However, the European Convention on Human Rights and the British Human Rights Act 1998 may yet do so.

No way out? The restraint of incapacitated patients

Clinical Risk ◽  
2007 ◽  
Vol 13 (5) ◽  
pp. 208-210
Author(s):  
Simon Lindsay
Keyword(s):  
Incapacitated Patients

Patient Confidentiality and the Surrogate's Right to Know

2000 ◽  
Vol 28 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Lynn A. Jansen ◽  
Lainie Friedman Ross
Keyword(s):  
Treatment Decisions ◽  
Decision Makers ◽  
Best Interests ◽  
Right To Know ◽  
Patient Confidentiality ◽  
Surrogate Decision Makers ◽  
Incapacitated Patients ◽  
Surrogate Decision

Physicians treating newly incapacitated patients often must navigate surrogate decision-makers through a difficult course of treatment decisions. Such a process can be complex. Physicians must not only explain the medical facts and prognosis to the surrogate, but also attempt to ensure that the surrogate arrives at decisions that are consistent with the patient's own values and wishes. Where these values and wishes are unknown, physicians must help surrogates make decisions that reflect the patient's best interests.

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