Anselm Eldergill: The Court of Protection and the Mental Capacity Act: Capaci...Darius Whelan
Judge Anselm Eldergill, Court of Protection
The Court of Protection and the Mental Capacity Act: Capacity to Change?
Presented at Mental Health Law Conference 2015 - Centre for Criminal Justice & Human Rights, School of Law, University College Cork and Irish Mental Health Lawyers Association
25 April 2015
http://www.imhla.ie
#mhlaw2015
Aim
To provide a practical understanding of the central concepts of the Mental Capacity Act using a real case
Objectives
• Understand concept of Mental Capacity
• Know how to assess capacity and apply it practically • Understand the concept of best interests
• Be able to describe a best interests assessment
Anselm Eldergill: The Court of Protection and the Mental Capacity Act: Capaci...Darius Whelan
Judge Anselm Eldergill, Court of Protection
The Court of Protection and the Mental Capacity Act: Capacity to Change?
Presented at Mental Health Law Conference 2015 - Centre for Criminal Justice & Human Rights, School of Law, University College Cork and Irish Mental Health Lawyers Association
25 April 2015
http://www.imhla.ie
#mhlaw2015
Aim
To provide a practical understanding of the central concepts of the Mental Capacity Act using a real case
Objectives
• Understand concept of Mental Capacity
• Know how to assess capacity and apply it practically • Understand the concept of best interests
• Be able to describe a best interests assessment
Legal aspects of aging slideshareversionmargigould
Presentation to MD3 (3rd year Doctor of Medicine), ERC (Extended Rural Cohort) students at the Rural Health Academic Centre in Shepparton planned for Wednesday 12/2/2014 on legal aspects of ageing covering capacity, powers of attorney, advance care plans, advance health directives, elder abuse, fitness to drive, prognostic guidance
Social care information packs
This is a series of short information sheets and matching slide sets about how social care staff can support people with learning disabilities to have better access to health services. They provide an introduction to each area and links to where further information and useful resources can be found.
Justice or Just Us: Understanding Bias and Managing Health Professional Lice...Harry Nelson
Presentation to the National Medical Association on the issue of bias in Medical Board and other health professional licensing and enforcement and recommendations for preventing and managing investigations.
Learning Telehealth in the Midst of a PandemicJohn Gavazzi
This presentation outlines the basics of beginning to work with patients via telehealth. The workshop offers both pragmatic and technical assistance to start working with patients at a distance or online
Got the ADA basics down and ready to tackle the graduate level course on the complex ADA issues that trip up even the best of HR and legal professionals? Gary Clark and Will Walden will tackle complex ADA issues, such as:
-Mental illness accommodations in the workplace
-The intersection between the ADA and workplace violence threats
-Medical marijuana, opioid and prescription drug use in the workplace
-Navigating a direct threat to health and safety decision
-Fitness for duty tests and examinations
-Managing employees on extended leaves after FMLA has expired
-Identifying accommodations that previously were per se unreasonable, but now must be considered
Please join Gary and Will as they cover these and other tough ADA issues in the workplace.
This talk covers ethical dilemmas in Neurology/Neurosurgery clinical practice, and the practical ways of dealing with those ethical dilemmas. There are guidelines available for these dilemmas. Following them would help in our clinical practice.
In Episode 5, John continues to outline relevant factors related to ethical decision-making. The psychologist's fiduciary responsibility is emphasized. Additionally, John outlines one ethical decision-making model as well as cognitive biases and emotional factors involved with ethical decision-making. John will make suggestions on how to improve ethical decision-making.
This guide is designed to help health and social care professionals understand and implement the law relating to advance decisions to refuse treatment (ADRT) contained in the Mental Capacity Act (2005).
This 2013 version replaces that published in September 2008 and covers:
How to make an advance decision to refuse treatment, who can make an advance decision, when a decision should be reviewed and how it can changed or withdrawn
What should be included
Rules applying to advance decisions to refuse life sustaining treatment and how they relate to other rules about decision-making
How to decide on the existence, validity and applicability of advance decisions and what healthcare professionals should do if an advance decision is not valid or applicable
The implications for healthcare professionals of advance care decisions, including situations where a healthcare professional has a conscientious objection to stopping or providing life-sustaining treatment
What happens if there is a disagreement about an advance decision.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
Legal aspects of aging slideshareversionmargigould
Presentation to MD3 (3rd year Doctor of Medicine), ERC (Extended Rural Cohort) students at the Rural Health Academic Centre in Shepparton planned for Wednesday 12/2/2014 on legal aspects of ageing covering capacity, powers of attorney, advance care plans, advance health directives, elder abuse, fitness to drive, prognostic guidance
Social care information packs
This is a series of short information sheets and matching slide sets about how social care staff can support people with learning disabilities to have better access to health services. They provide an introduction to each area and links to where further information and useful resources can be found.
Justice or Just Us: Understanding Bias and Managing Health Professional Lice...Harry Nelson
Presentation to the National Medical Association on the issue of bias in Medical Board and other health professional licensing and enforcement and recommendations for preventing and managing investigations.
Learning Telehealth in the Midst of a PandemicJohn Gavazzi
This presentation outlines the basics of beginning to work with patients via telehealth. The workshop offers both pragmatic and technical assistance to start working with patients at a distance or online
Got the ADA basics down and ready to tackle the graduate level course on the complex ADA issues that trip up even the best of HR and legal professionals? Gary Clark and Will Walden will tackle complex ADA issues, such as:
-Mental illness accommodations in the workplace
-The intersection between the ADA and workplace violence threats
-Medical marijuana, opioid and prescription drug use in the workplace
-Navigating a direct threat to health and safety decision
-Fitness for duty tests and examinations
-Managing employees on extended leaves after FMLA has expired
-Identifying accommodations that previously were per se unreasonable, but now must be considered
Please join Gary and Will as they cover these and other tough ADA issues in the workplace.
This talk covers ethical dilemmas in Neurology/Neurosurgery clinical practice, and the practical ways of dealing with those ethical dilemmas. There are guidelines available for these dilemmas. Following them would help in our clinical practice.
In Episode 5, John continues to outline relevant factors related to ethical decision-making. The psychologist's fiduciary responsibility is emphasized. Additionally, John outlines one ethical decision-making model as well as cognitive biases and emotional factors involved with ethical decision-making. John will make suggestions on how to improve ethical decision-making.
This guide is designed to help health and social care professionals understand and implement the law relating to advance decisions to refuse treatment (ADRT) contained in the Mental Capacity Act (2005).
This 2013 version replaces that published in September 2008 and covers:
How to make an advance decision to refuse treatment, who can make an advance decision, when a decision should be reviewed and how it can changed or withdrawn
What should be included
Rules applying to advance decisions to refuse life sustaining treatment and how they relate to other rules about decision-making
How to decide on the existence, validity and applicability of advance decisions and what healthcare professionals should do if an advance decision is not valid or applicable
The implications for healthcare professionals of advance care decisions, including situations where a healthcare professional has a conscientious objection to stopping or providing life-sustaining treatment
What happens if there is a disagreement about an advance decision.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
Ethical issues of Care of elderly patients:-
Decision making capacity.
Informed consent.
Refusal of treatment.
Advance directive.
Major ethical principles.
Psycho-social aspects of aging.
Legal, Clinical, Risk Management and Ethical Issues in Mental HealthJohn Gavazzi
The program outlines the fundamental differences between clinical issues, legal questions, risk management strategies, and ethical issues. While overlap exists, ethical questions arise when there are two competing ethical principles at odds. The course will reference both the ACA and the NBCC Code of Ethics. Clinical issues deal with treatment-oriented concerns. Legal issues concern state, federal, and case law, as well as statutes and regulations. Risk management typically focuses on reducing liability. Several case examples will be given to demonstrate how these issues overlap and are important to high quality of care.
Shari McDaid - The Mental Health Act 2001: Issues from a Coalition PerspectiveDarius Whelan
Dr Shari McDaid - The Mental Health Act 2001: Issues from a Coalition Perspective
Dr Shari McDaid is the Director of Mental Health Reform.
Presented at Mental Health Law Conference 2015 - Centre for Criminal Justice & Human Rights, School of Law, University College Cork and Irish Mental Health Lawyers Association.
25 April 2015
http://www.imhla.ie
#mhlaw2015
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
1. The Mental Capacity Act:
Capacity Assessments
Advance Decisions
& Lasting Power of Attorney
Dan Bailey
King’s College Hospital
May 2017
2. Aim and Objectives
Aim
To provide a practical understanding of the central concepts
of the Mental Capacity Act using a real case
Objectives
• Understand concept of Mental Capacity
• Know how to assess capacity and apply it practically
• Understand the concept of advance decisions and LPA
• Know how to manage a patient with either advance
decisions and LPA
7. The Mental Capacity Act gave structure to
a complex legal situation
Replaced “common” (Court) law
concerning people who lacked capacity
Introduced new tools and powers:
Capacity assessment
Best Interest Process
Advance Decision Making
Capacity assessment
Best Interest Process
8. The Act has 5 Core Principles…
1 Presumption of capacity in people 18+
5
3
2 Reasonable help to make a decision
Allow people to make unwise choices
Acts done for/on behalf must be in
best interests
Best Interests = less restrictive
course, respecting rights/freedom of
action
4
9. It’s time to introduce Frank
74 Year old Man
PD
Lewy Body Dementia
#NOF
From Residential Home
Walks short distances
with frame
Unable to swallow
10. You are called to see Frank
when on call…
NG Feed has been in situ
Pulled out tube
Refusing re-insertion
Poor iv access
11. Before you test for capacity you must do
one thing…
KNOW WHAT THE
DECISION IS THAT
THE PERSON HAS
TO MAKE
12. The test for capacity has 2 stages…
Impairment of the
functioning of the
mind/brain
Firstly you must have…
If the person does not
meet this criterion then
they have capacity to
make the decision in
question
13. The second stage is the functional test…
Criterion
Understand
information
Test
Risks Benefits All
Options
No
Decision
Retain
information
Duration of
conversation
Use/Weigh
information
Show their
“working”
How did they arrive
at the decision?
Communicate Through any
means
14. How sure do you have to be?
BALANCE OF
PROBABILITIES…
Is it more likely than not
that the person has
capacity?
15. How to record the test?
Record keeping: “Professionals should never express an opinion without carrying out a proper
examination and assessment of the person’s capacity to make the decision” [para 4.52]
• NO statutory form – create your own or write in notes
• Impairment / disturbance and age 16+
• Date and decision to be made
• Test of capacity
Mr Jones could not
understand the
information . . .
- Understand
- Retain
- Use / Weigh
- Communicate
OR
• Practicable steps taken? NOTE: emergency care
Detail can be brief for simple and daily care BUT record more detail for complex or
important decisions [living at home or serious treatment] or where others may disagree
How do you record it?
16. Frank’s wife comes to the
ward waving a piece of paper
…
“I have a living will, do not
touch him, or I will call the
police!”
17. Advance Decisions
Synonymous with “Advance Directives”
Arise from doctrine of respect for
autonomy:
“How are we best to maintain autonomous
control of our lives, despite an envisaged
period of incompetence?”
18. Advance Decisions
Common law previously upheld right to
self determination through refusal of Rx
which might result in death…
Re:C, Re:B
Also established precedent for legally
binding advance refusals of treatment…
Re: AK [2001]
19. Advance Decisions
Re: AK in 2001 was the only case in which AD
was held to be effective and valid.
Subsequent cases HE v A Hospital Trust and W
Healthcare NHS Trust v H set out criteria where
AD may not be valid.
Overall if you made AD law was not clear as to
whether it would be upheld or not
20. Advance Decisions
Can be legally binding on healthcare
professionals
Failure to follow an Advance Decision
could lead to:
Liability in battery
A criminal charge for assault
22. How common are Advance
Decisions?
No official statistics
Thought to increase in number over forthcoming
years
Patients can refuse all kinds of treatment
NHS staff already deal with AD in everyday
work
Jehovah’s Witnesses
DNR forms
23. “Valid and Applicable Advance
Directive….”
What does this mean?
How do you tell?
Could most doctors identify criteria for
applicability and validity?
24. Basic Principles
Apply to >18s
Must satisfy certain validity/applicability
criteria
Have the same effect as if the person is
refusing contemporaneously
No specific form
25. General Validity Criteria
Valid if not withdrawn
Valid if there is no LPA which confers decision
making in this matter on a deputy [made after
AD]
Not valid if there has been inconsistent
behaviour
HE v NHST H
26. General Applicability Criteria
Applicable only once capacity lost!
Treatment must be specified
Relevant circumstances specified
[W NHST v H]
Unanticipated circumstances [HE V NHST H]
Special circumstances for refusal of life-
sustaining treatment
27. How to Formulate…
Fill out DNR form
Write in notes:
“In the event of a cardiopulmonary arrest,
I, Mark, do not wish to have resuscitation,
even if my life is at risk”
Patient signature
Witness signature
28. Practicalities
“I’m not sure that any 45 year old who refuses
resuscitation is competent…”
“A person must be assumed to have capacity
unless it is established that he lacks capacity”
s1(2)
“ A person is not to be treated as unable to
make a decision merely because he makes
an unwise decision”s1(4)
29. Practicalities
Code of Practice [9.8]:
• Healthcare professionals should always start from the
assumption that a person who has made an advance
decision had the capacity to make it
• Unless they are aware of reasonable grounds to doubt
that the person had capacity at that time
• If healthcare professional not satisfied of this then they can
treat without fear of liability
30. Practicalities
In emergencies what efforts should be
made to discover if an AD exists?
AD will trump earlier LPA
If valid and applicable then there is no
best interests principle [COP 9.36]
31. Practicalities
Can refuse all treatment including ANH
Cannot make advance requests
Cannot request anything currently illegal - e.g.
euthanasia
Code of practice states unable to refuse basic
care [food/shelter/warmth + ? Analgesia] - not
binding
32. Practicalities
No liability for continuing to treat unless
satisfied valid/applicable AD
No liability for witholding treatments if
reasonable belief valid AD exists
Can apply to Court of Protection for declaration
of validity of advance directive
33. Court of Protection
Can only give statement as to validity or
applicability of AD
Cannot overturn valid and applicable AD
Preservation of life allowed whilst awaiting
a court decision
Act states that where there is doubt act to
preserve life
34. Legal Problems
No chance to interact with decision maker
Assessor’s opinion of capacity will have to be
based on rationality of AD
Irrational AD will be vulnerable to finding
author is incompetent
No requirement of sufficient information cf
consent
35. Legal Problems
No requirement to lodge/record AD with
anyone
COP suggests
Carrying a card or bracelet
Keeping copy in healthcare notes
Keeping copy with GP
36. Legal Problems
Compare AD with LPA
20+ page document
Must lodge with Office of Public Guardian
Date stamped and signed on every page
By March 08 – 4,400 applications for LPA
(Equivalent to 52,800 pa)
In April 08 – 6,000 applications (72,000 pa)
37. Ethical Concerns
Not possible to predict future events so no AD
can ever be truly autonomous
Patients have problems dealing with
contemporaneous refusals
People underestimate quality of life of
disabled/demented – substituted judgement
38. Ethical Problems
Potential for denying author benefits of
advances in care
Author unable to change mind once
incompetent
39. Ethical Problems
Personal Identity Problem, “Margo”…
When a person loses competence, are they still the
same person as they were before?
If not then can one person’s decision be binding on
another?
Are incompetent people even “persons”?
40. Ethical Problems
What is the nature of the relationship
between the two?
Issues of body continuity?
Issues of mental continuity?
Psychological connectedness [per Parfit]?
Critical vs Experiential Interests [per Dworkin]?
A parent-child relationship [per Maclean]?
41. Final Thoughts
Think about mental
capacity
Know what decision has to
be made by the patient
Advance decisions can be
legally binding on health
care professionals
Law favours balance
towards preservation of life
MCA opens up a dialogue to
answer questions
42. References
The Mental Capacity Act 2005, Chapter 9, s1 and ss24-26,
http://www.opsi.gov.uk/acts/acts2005/ukpga_20050009_en_1, accessed on 10th
December 2007.
The Mental Capacity Act 2005: Code of Practice, Ch 9,
http://www.opsi.gov.uk/acts/acts2005/related/ukpgacop_20050009_en.pdf,
accessed on 10th December 2007. Re: AK [2001] 1 FLR 129
HE v NHS Trust H [2005] EWHC 107
Office of Public Guardian Annual Report, 2008,
http://www.publicguardian.gov.uk/docs/opg-annuual-report-2007-08.pdf,
accessed on 30th October 2008.
W Healthcare NHS Trust v H [2005] 1 WLR 834
A Maclean, Advance directives, future selves and decision-making (2006) 14
Med L rev 291
A Maclean, Advance directives and the rocky waters of anticipatory decision
making (2008) Med L Rev
Emily Jackson, Medical Law: Text, Cases and Materials (2006), Oxford: Oxford
University Press