Medical Ethics and Law
Contents
Core Principles in Medical Ethics and Law..............................................................................................1
Mental Capacity Act, Consent and Best Interests in practice.................................................................1
Honesty, truth-telling and Duty of Candour...........................................................................................2
Ethical Issues: Sustainability, Climate and Responsibilities in Medicine.................................................2
Core Principles in Medical Ethics and Law
- Core Principles: Confidentiality, Consent, Autonomy (self-determination/rule, linked with
issues of consent and capacity), Balancing harms and benefits, Justice
- Ethical solutions: usually not best option but a least harmful option
- Moral principles (competing): improve health, comfort, dignity; prevent harm and death,
autonomous decision-making, confidentiality, resources
- Guides: ethical principles, law, professional guidelines (GMC; College guidelines)
Mental Capacity Act, Consent and Best Interests in
practice
- Basic: if patient has capacity they decide for themselves and must give consent, if patient
doesn’t have capacity treating clinicians decide in the patients best interest
- Mental capacity act- 5 principles: every over 16y old has own to make own decision, person
must be given help before treated as uncapable, just because what might seen as unswise
decision they should not be treated as lacking capacity, any decision made on behalf of a
person who lacks capacity must be made in their best interest and must be the least
restrictive of their basic rights and freedoms
- Capacity legal assessment: understand and retain information, weigh it up as part of process
of making decisions, communicate the decision
- Two stage test: impairment of mind or brain (temp or permanent)?, if yes is person unable to
make own decisions (time and decision specific)
- Best interest process: consider all relevant information, balance sheet approach (harms and
benefits), consider the possibility of future capacity, find out persons view (past and present
wishes and feelings, beliefs / values, other factors)
Avoid discrimination, choose least restrictive option, if decision about life-sustaining
treatment decision must be motivated by a desire to bring about death
- Independent Mental capacity advocate (IMCA): additional safeguard, someone independent
from NHS
- Court of protection: deals with all areas of decision making for people who lack capacity
(property, finance, etc), will resolves disputes
- Consent: need to make legitimate acts that might otherwise be seen as assault, patients own
decision, limit liability of the practitioner
- Legal principles: proceeding without consent (battery), proceeding without appropriate
information and understanding (negligence)
