By Sapna Mehta, Dennis John Kuo. Teenagers, and indeed all children to various extents, live in a world that does not recognize their independence fully. In various situations, they find their rights being exercised by and interests being defined by parents as well as other authorities such as physicians, teachers and the state to a […]
Category: consent
Vulnerable adults can be autonomous. Assuming that they are not is wrong and harmful.
By Jonathan Lewis. With the establishment of the Mental Capacity Act (“MCA”) 2005 in England and Wales, the days of court interventions into the lives of adults with mental capacity seemed numbered. If you were an adult with capacity, then you were legally recognised as able to give genuine consent to care and medical treatments. […]
“We think you may be at risk of a genetic disease”. Should direct-to-consumer genetic testing companies contact at-risk relatives?
By Philip E Baker and Jordan A Parsons. Direct-to-consumer (DTC) genetic testing is becoming increasingly popular. However, with genetic testing comes the possibility of discovering mutations that confer increased risk of genetic diseases not only to the tested individual (the proband), but also their genetic relatives. This raises the challenging ethical question of what should […]
Why do we need to distinguish ‘valid’ and ‘informed’ consent to medical treatment?
By Emma Cave. Common law and ethics require that consent is voluntary, that it is made by a person with capacity and that it is sufficiently informed. But it does not follow that consent that is insufficiently informed will necessarily be considered in law to be invalid. Since Montgomery in 2015, the requirement of informed […]
Refusal redux: Revisiting debate about adolescent refusal of treatment
By Dominic Wilkinson. Last month, in an emergency hearing, the High court in London heard a case that characterises a familiar problem in medical ethics. A 15 year old adolescent (known as ‘X’) with a long-standing medical condition, sickle cell disease, had a very low blood count and required an urgent blood transfusion. However, X […]
Consent and living organ donation
By Maximilian Kiener. Many people feel very gratified if they can donate an organ to their child or spouse in need. Others, however, are extremely frightened and secretly hope not to be compatible. In interviews, they admit to be ‘scared to death’ and ‘terrified all the way down.’ Yet, many of the most frightened eventually […]
Bad news about prognosis: why is it still so difficult?
By Nicola Grignoli. Today the team of the internal medicine ward asked me as a psychologist to participate in a family meeting: a patient with mental disorder was to be told of a life-threatening illness. We discussed whether the patient had to be present or if the bad news should be disclosed to the partner […]
Does consent make open label placebo research ethical?
By Laura Specker Sullivan Open label placebo studies hypothesize that placebos can be effective even when there is complete transparency about what participants are given. These studies are being run for conditions such as chronic pain, cancer-related fatigue, and irritable bowel syndrome. Open label placebos have garnered significant interest in the popular imagination, perhaps due […]
Do No Harm in cancer screening programmes: can consent save the day?
By Lotte Elton Screening might harm you. That isn’t what the adverts will tell you. But, increasingly, there is a growing awareness that, for some, cancer screening might lead to unnecessary and potentially harmful investigations and treatments. This seems to violate the ethical principle of non-maleficence: the injunction that doctors ‘do no harm’ to their […]
What end of life care do we want to give to persons with end-stage dementia?
By Joseph Dimech, Emmanuel Agius, Julian C Hughes and Paul Bartolo. Dementia is a degenerative neurocognitive disorder that leads to a high level of physical and cognitive disability as the disease progresses to its end-stage. Such patients are also at high risk of suffering from co-morbidities, including aspiration pneumonia secondary to swallowing difficulties. Thus, such […]