By Abeezar I. Sarela. In its recent guidance on consent, the General Medical Council (GMC) advises doctors to not provide treatment that ‘you (the doctor) don’t think would be in their (the patient’s) clinical interests’. It follows that doctors should only provide treatments that are in the patient’s clinical interests. But, what exactly is meant […]
Category: Decision making
Meeting the challenges of using automated second opinions
By Hendrik Kempt and Saskia K. Nagel. Diagnostics is a difficult inferential process requiring an immense amount of cognitive labor. Not only must physicians gather evidence and evaluate that evidence to fit the symptoms of a patient, they usually need to do that with imperfect knowledge in an ever changing field of research, and limited […]
How to apply the MCA capacity criteria more transparently and reliably
By Scott Kim, Nuala Kane, Alex Ruck Keene, Gareth Owen. A lot is at stake in a mental capacity evaluation. An error can lead to a capacitous adult’s decision being ignored or even overruled, or to a vulnerable, incapacitous person being abandoned to their ‘rights.’ Unfortunately, there is no simple formula that generates the right […]
Is medico-legal paternalism still rife in UK paediatric best interest decisions?
By Michal Pruski. The UK case of Alta Fixsler is reigniting the debate on paediatric best interest decisions in the case of end of life considerations. The two-year old’s Jewish parents want her to be transferred to Israel to be taken care of by clinicians sharing their religious and moral outlooks. Meanwhile the NHS trust […]
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. […]
The current call for a (fresh) inquiry on assisted suicide
By Nataly Papadopoulou. As a society and as individuals, we face challenges in dealing with debilitating, horrible diseases causing suffering, indignity, and loss of autonomy. With increased emphasis on individual autonomy in a clinical but also in a legal setting, some patients wish to control the end of their lives. Perhaps one of the most […]
Covid-19: value-based policy making
By Jonathan Michaels. While claiming to be ‘following the science’ politicians in many countries have implemented a range of widely differing policies in relation to Covid-19. This week, the UK government has reopened various parts of the economy in England, including pubs and restaurants, hairdressers and cinemas. Evidence-based decision making is not value-free. In framing […]