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where doctors and families are in agreement they should not have to go to court to seek permission for treatment to be withdrawn from patients in a persistent vegetative or minimally conscious state.”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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Debate: The Fiction of an Interest in Death? Justice for Charlie Gard

JME Blog, 26 April 2017
Author: Julian Savulescu
“A judge ruled last week that baby Charlie Gard will have his treatment withdrawn, against the wishes of his parents. His doctors argued that the rare mitochondrial disease (MDDS) he was born with was causing him unbearable suffering. His parents had raised funds to take him to the US for experimental treatment and they wanted the chance to try the treatment. His doctors argued that such treatment could only prolong his suffering. It was their belief that it was in his best interests for treatment to be withdrawn, and for his life to end, a belief which the trial judge endorsed.”
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Is decision-making capacity an “essentially contested” concept in pediatrics?

Med Health Care and Philos (2017). doi:10.1007/s11019-017-9768-z
Authors: Eva De Clercq, Katharina Ruhe, Michel Rost, Bernice Elger
“Key legislations in many countries emphasize the importance of involving children in decisions regarding their own health at a level commensurate with their age and capacities. Research is engaged in developing tools to assess capacity in children in order to facilitate their responsible involvement. These instruments, however, are usually based on the cognitive criteria for capacity assessment as defined by Appelbaum and Grisso and thus ill adapted to address the life-situation of children. The aim of this paper is to revisit and critically reflect upon the current definitions of decision-making capacity.”
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Presumed consent: licenses and limits inferred from the case of geriatric hip fractures

BMC Medical Ethics 2017 18:17
Authors: Joseph Bernstein, Drake LeBrun, Duncan MacCourt, Jaimo Ahn
“Hip fractures are common and serious injuries in the geriatric population. Obtaining informed consent for surgery in geriatric patients can be difficult due to the high prevalence of comorbid cognitive impairment. Given that virtually all patients with hip fractures eventually undergo surgery, and given that delays in surgery are associated with increased mortality, we argue that there are select instances in which it may be ethically permissible, and indeed clinically preferable, to initiate surgical treatment in cognitively impaired patients under the doctrine of presumed consent.”
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