Woman who rejected breast cancer diagnosis may undergo surgery without her consent

BMJ 2017; 359: j5358
Author: Clare Dyer
“A 66 year old woman with paranoid schizophrenia may be put under general anaesthetic and have surgery for breast cancer without her consent, a High Court judge has ruled. Mr Justice Keehan declared that the woman, referred to as JT, who denied that she had cancer, lacked the capacity to decide for herself whether to have the treatment.”
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Woman in minimally conscious state should be allowed to die, says judge after hearing evidence from family

BMJ 2017; 359: j5138
Author: Clare Dyer
“A 72 year old woman in a minimally conscious state who was kept alive by artificial feeding would have found her situation “not only intolerable but humiliating” and it would be in her best interests to withdraw feeding, a High Court judge has said.”
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Conflicting interpretations or conflicting opinions? Being clear about the UN-CRPD

JME Blog, 3 November 2017
Authors: Matthé Scholten, Jakov Gather
“When a patient is incompetent to make a particular treatment decision due to impaired decision-making capacity, it is common practice that the decision is based on an advance directive or made by a substitute decision-maker on behalf of the patient. The substitute decision-maker’s task is to choose the treatment option that the patient would have chosen had he or she been competent. Recent reports prepared by the United Nations (UN) strongly repudiate this practice. According to these reports, article 12 of the UN Convention on the Rights of Persons with Disabilities (CRPD) states that persons with mental disabilities may on no account be denied the right to make their own treatment decisions.”
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Family in dispute over care of woman with brain damage

The Guardian, 17 October 2017
Author: Josh Halliday
“A family is in dispute over the ongoing care of a woman with brain damage who had suggested she would want to die in such circumstances, a court has heard. The woman, identified as Mrs P, is said to be in a “minimally conscious state” on an acute hospital ward following a fall last year. A Court of Protection judge is being asked to consider whether she should continue to receive clinically assisted nutrition and hydration.”
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Why I needed to let my little brother die

The Guardian, 26 September 2017
Author: Cathy Rentzenbrink
“Everyone involved was compassionate, and I have always felt grateful that they tried not to make it horrible for us. But it was horrible. That’s why I welcomed last week’s ruling by Mr Justice Peter Jackson that in future, where doctors and families are in agreement they should not have to go to court to seek permission for treatment to be withdrawn from patients in a persistent vegetative or minimally conscious state.”
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Charlie Gard’s parents make emergency appeal to European judges

The Guardian, 9 June 2017
Author: Owen Bowcott
“Established human rights law dictates that the rights of a child should take precedence over the rights of their parent, Hale stressed in her decision. “The child’s interests must prevail,” she said. Lawyers for the child’s guardian appointed by the court have argued against sending Charlie to the US, saying that the proposed treatment would be futile.”
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The Voluntary Nature of Decision-Making in Addiction: Static Metaphysical Views Versus Epistemologically Dynamic Views

Bioethics, 31: 349–359. 2017. doi:10.1111/bioe.12356
Authors: Racine, E. and Rousseau-Lesage, S.
“The degree of autonomy present in the choices made by individuals with an addiction, notably in the context of research, is unclear and debated. Some have argued that addiction, as it is commonly understood, prevents people from having sufficient decision-making capacity or self-control to engage in choices involving substances to which they have an addiction. Others have criticized this position for being too radical and have counter-argued in favour of the full autonomy of people with an addiction. Aligning ourselves with middle-ground positions between these two extremes, we flesh out an account of voluntary action that makes room for finer-grained analyses than the proposed all-or-nothing stances, which rely on a rather static metaphysical understanding of the nature of the voluntariness of action.”
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Debate Reponse: Charlie Gard, Interests and Justice – an alternative view

JME Blog, 26 April 2017
Author: Dominic Wilkinson
“The sad and difficult case of Charlie Gard, which featured in the media last week, is the latest in a series of High Court and Family court cases when parents and doctors have disagreed about medical treatment for a child. Doctors regard the treatment as “futile” or “potentially inappropriate”. Parents, in contrast, want treatment to continue, perhaps in the hope that the child’s condition will improve. In the Charlie Gard case, the judge, Justice Francis, rejected Charlie’s parents’ request for him to travel to the US for an experimental medical treatment. He ruled that life-sustaining treatment could be withdrawn, and Charlie allowed to die.”
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