Does the General Medical Council’s 2020 guidance on consent advance on its 2008 guidance?

The General Medical Council renewed its guidance on consent in 2020. In this essay, I argue that the 2020 guidance does not advance on the earlier, 2008 guidance in regard to treatments that doctors are obliged to offer to patients. In both, doctors are instructed to not provide treatments that are not in the overall benefit, or clinical interests, of the patient; although, patients are absolutely entitled to decline treatment. As such, consent has two aspects, and different standards apply to each aspect. To explore this paradigm, I propose the reconceptualisation of consent as a person’s freedom to achieve treatment, using Amartya Sen’s approach. Sen explains that freedom has two aspects: process and opportunity. Accordingly, a patient’s freedom to achieve treatment would comprise a process for the identification of proper treatment, followed by an opportunity for the patient to accept or decline this treatment. As per Sen, the opportunity aspect is to be assessed by the standard of public reason, whereas the standard for the process aspect is variable and contingent on the task at hand. I then use this reconceptualised view of consent to analyse case law. I show that senior judges have conceived the patient’s opportunity to be encompassed in information, which is to be decided by public reason. On the other hand, the process aspect relies on the private reason of medical professionals. Given the nature of professionalism, this reliance is inescapable, and it is maintained in the case law that is cited in both guidances.

Blasphemy As A Thick Concept

Thick concepts have been central in metaethical debates over the last few decades, for instance in the controversy between cognitivism and non-cognitisivism or in the fact/value distinction. They are characterised as world guided, action guiding and community shared. In this paper, thick concepts are used to analyse case law on blasphemy from the European Court of Human Rights. When conducting this analysis, the test of civility proposed by Habermas and Rawls will also be applied. Public reason obligates the use of reasons accessible to all, that is to say not with a particular/thick meaning, in the public sphere.

Od predmeta Mccann do predmeta F.J.M.

The authors discuss and analyse case law of the European Court of Human Rights regarding the right to respect for home under Article 8 of the European Convention for the Protection of Human Rights and Fundamental Freedoms and with respect the issue of proportionality. In the paper, the proportionality category was viewed as a criterion for securing protection and as a material precondition for deciding whether the State party's interference with the right to respect for home was proportionate. The cases in which the applicant's eviction occurred after national proceedings for the enforcement of mortgages were addressed. In this context, the genesis of the proportionality category was analysed, from the cases where the Court found it necessary to examine the proportionality to the cases where the Court did not consider the proportionality test necessary.

Engineering the Roadmap of Reverse Innovation

The reverse innovation concept has gained traction in the practitioner and academic domains since it alters the traditional view of innovations flowing from developed countries to emerging markets. Reverse innovations depart from the assumption that product development appeals to value offers with reduced performance and radically lower price points for consumers in emerging markets. Existing literature on reverse innovations has been limited to analyse case studies and anecdotic evidence but a systematic framework is needed to innovate in systematic ways. Drawing from the technology planning and forecasting, this paper proposes that technology roadmaps are suitable tools to analyse how a reverse innovation designed initially in an emerging market encroaches developed countries. At the firm level, roadmaps integrate technology planning, product development, and market aspects. Hence, they become suitable tools to design and commercialize products and services based on the reverse innovation paradigm.

“You can’t be up there” – youth cultural participation and appropriation of space

This article investigates the relationship between youth cultural practices and young people’s spatial appropriation. For this purpose, we analyse case studies into groups of young people involved in two forms of practices that are marked by particular perceptions of the (urban) space: two Parkour groups and a Scouts group. The questions we are dealing with concern the way to which young members of these groups are appropriating ‘free space’ through participating in activities like the Scouts or Parkour. Furthermore, this article also explores important questions concerning processes of how young people’s participation in urban areas should be understood and what consequences this understanding has for youth policy.

Realigning alignment

We analyse case marking in the Jê language family (Brazilian Amazonia) with the new completeness alignment typology proposed by Lindenbergh & Zwart (2017). In contrast with classical alignment typology, the completeness typology first determines whether all grammatical functions participate in a grammatical process (e.g. case marking) and only then determines how these grammatical functions are aligned, adding nine incomplete alignment types to the five types of classical alignment typology. Nine of the ten Jê languages are classified as split-ergative, while Panará is seen as fully ergative, making it a typologically odd language within the family. We show that applying the completeness typology to Jê languages more accurately describes the true variation in case marking patterns across the Jê language family.

Engineering the Roadmap of Reverse Innovation

The reverse innovation concept has gained traction in the practitioner and academic domains since it alters the traditional view of innovations flowing from developed countries to emerging markets. Reverse innovations depart from the assumption that product development appeals to value offers with reduced performance and radically lower price points for consumers in emerging markets. Existing literature on reverse innovations has been limited to analyse case studies and anecdotic evidence but a systematic framework is needed to innovate in systematic ways. Drawing from the technology planning and forecasting, this paper proposes that technology roadmaps are suitable tools to analyse how a reverse innovation designed initially in an emerging market encroaches developed countries. At the firm level, roadmaps integrate technology planning, product development, and market aspects. Hence, they become suitable tools to design and commercialize products and services based on the reverse innovation paradigm.

An evaluation of the use of electroconvulsive therapy in a United Kingdom high secure psychiatric hospital

IntroductionElectroconvulsive therapy (ECT) is an effective NICE-approved treatment for severe depression, treatment-resistant mania and catatonia; the Royal College of Psychiatrists’ (RCPsych) guidelines also support its use fourth line for treatment-resistant schizophrenia.ObjectivesEvaluate the use of ECT at Broadmoor High Secure psychiatric hospital, focusing on the indications for its prescription and patients’ capacity to consent.MethodAnalyse case records of all patients who received ECT, and of all patients referred for Second Opinion Appointed Doctor (SOAD) certified ECT treatment under Section 58 of the Mental Health Act 1983 (MHA) due to incapacity, between 01.09.11 and 30.07.15.ResultsAll patients lacked capacity to consent to treatment during this time. Thirty-three referrals were made to the SOAD service for 15 patients, and of these 30 resulted in certification (T6) of which 10 were not subsequently used. Improvements in mental state and agreement to take clozapine were common reasons for T6s either not being certified or used. Urgent treatment under Section 62 of the MHA was employed 7 times for 4 patients during this period. Of the referrals to the SOAD service, 25 were for treatment-resistant schizophrenia, 5 for mania, 3 for catatonia and none for depression.ConclusionsThose patients requiring ECT within this population tended to be the most unwell and all lacked the capacity to consent to it. The majority (76%) of patients receiving ECT at Broadmoor do so outside of NICE (but within RCPsych) guidelines. ECT may be an effective strategy for promoting compliance with clozapine.Disclosure of interestThe authors have not supplied their declaration of competing interest.