Autonomy and welfare as amici curiae

Medical Law Review

Volumn 18, Issue 1, 2010, Pages 86-95

  Dunn, Michael ^a   Foster, Charles ^a  

^a UNIVERSITY OF OXFORD   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

AGED; ALZHEIMER DISEASE; ARTICLE; FEMALE; HARM REDUCTION; HUMAN; LEGAL ASPECT; MENTAL CAPACITY; PERSONAL AUTONOMY; PSYCHOLOGICAL ASPECT; UNITED KINGDOM;

AGED, 80 AND OVER; ALZHEIMER DISEASE; ENGLAND; FEMALE; HARM REDUCTION; HUMANS; MENTAL COMPETENCY; PERSONAL AUTONOMY;

EID: 77952490256     PISSN: 09670742     EISSN: 14643790     Source Type: Journal    
DOI: 10.1093/medlaw/fwp023     Document Type: Note

References (45)

1. For histories of the development of substitute decision-making for adults lacking capacity in the common law following Re F
2. see MC Dunn, ICH Clare, AJ Holland and MJ Gunn, 'Constructing and Reconstructing 'Best Interests': An Interpretative Examination of Substitute Decision-Making Under the Mental Capacity Act 2005' (2007) 29 J Soc Welf Fam Law 117
3. J Coggon, 'Best Interests, Public Interest, and the Power of the Medical Profession' (2008) 16 Health Care Anal 219
4. P Bartlett, Blackstone's Guide to the Mental Capacity Act 2005 (2nd edn Oxford University Press, Oxford 2008) 23-41
5. Mental Capacity Act 2005 s 5
6. [2009] EWHC 784 (Fam)
7. At n 3 [123]
8. See, for example, Re A (Male Sterilisation) [2001] 1 FLR 549
9. Simms v Simms (and another) [2002] EWHC 2734 (Fam).
10. Local Authority X v MM (by her litigation friend, the Official Solicitor) and KM [2007] EWHC 2003 (Fam)
11. At n 3 [6]; see also [31] and [123]
12. J Coggon, 'Varied and Principled Understandings of Autonomy in English Law: Justifiable Inconsistency or Blinkered Moralism?' (2007) 15 Health Care Anal 235
13. See, for example, TL Beauchamp and JF Childress, Principles of Biomedical Ethics (6th edn Oxford University Press, New York 2009) 100-2
14. Coggon (2007), above, n 7, 240
15. See also R Lindley, Autonomy (MacMillan, Basingstoke 1986)
16. See, for example, C Mackenzie and N Stoljar, Relational Autonomy: Feminist Perspectives on Autonomy, Agency and the Social Self (Oxford University Press, New York 2000)
17. EF Kittay, 'Beyond Autonomy and Paternalism: the Caring Transparent Self' in T Nys, Y Denier and T van de velde (eds) Autonomy and Paternalism: Between Independence and Good Intentions (Peeters, Leuven 2006) 1-29
18. At n 3 [80] and [83]
19. WS Korr, JA Encandela and D Brieland, 'Independence or Autonomy: Which is the Goal?' (2005) 28 Int J Law Psychiatry 290
20. Consider, for example, Gordon Brown's policy announcement in September 2009 to provide free personal care to older adults with the highest needs in their own homes as a 'good' in its own right, independent of any consideration of whether that care will enhance adults' well-being accessed 3 November 2009.
21. Nuffield Council on Bioethics Dementia: Ethical issues (Cambridge Publishers, Cambridge 2009) para 2.28.
22. Mental Capacity Act 2005 s 1(6), which provides: 'Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action'.
23. Mental Capacity Act 2005 Code of Practice para 2.16.
24. Mental Capacity Act 2003 s 6(1); Mental Capacity Act 2005 Deprivation of Liberty Safeguards, Code of Practice to supplement the main Mental Capacity Act 2005 Code of Practice para 1.1.
25. At n 3 [23-25]
26. See City of Sunderland v PS and CA [2007] EWHC 623 (Fam)
27. A Primary Care Trust v P, AH and A Local Authority [2008] 2 FLR 1196
28. Local Authority X v MM (by her litigation friend, the Official Solicitor) and KM [2007] EWHC 2003 (Fam)
29. See also Re SA (Vulnerable adult with capacity: marriage) [2006] 1 FLR 867
30. Re G (An adult) (Mental capacity: court's jurisdiction) [2004] EWHC 2222 (Fam)
31. See MC Dunn, ICH Clare and AJ Holland, 'To Empower or To Protect? Constructing the 'Vulnerable Adult' in English Law and Public Policy' (2008) 28 Leg Stud 234
32. At n 3 [57] and [77]
33. Mental Capacity Act 2005, above n 2, s 6; Mental Health Act 2007 Schedule 7-Mental Capacity Act 2005: new Schedule A1, s 16
34. The ethical issues arising out of the relationship between the legal requirement to act to prevent harm and to act in an adult's best interests are considered at length in S Behrman and MC Dunn, 'Physical Restraint of Medical Inpatients: Unravelling the Red Tape' (forthcoming) Clin Ethics
35. See MC Dunn, ICH Clare and AJ Holland, 'Living 'a Life like Ours': Support Workers' Accounts of Substitute Decision-Making in Residential Care Homes for Adults with Intellectual Disabilities' (forthcoming) J Intellect Disabil Res
36. Re SA, above, n 22, at [37]
37. See, for example, RM Gordon, 'Adult Protection Legislation in Canada: Models, Issues, and Problems' (2001) 24 Int J Law Psychiatry 117
38. Above, n 2 s 4
39. Above, n 3 at [123]
40. This conception of the interests of a person with dementia is taken from the ethical analytic framework developed by the Nuffield Council on Bioethics to address ethical issues in dementia care, above, n 14, para 2.25-2.39. This framework also considers the role that the interests of carers for people with dementia should play in resolving such dilemmas. Although we believe that the interests of carers are very important in the appropriate provision of dementia care, we exclude such interests in this particular legal context because of the requirements of the Mental Capacity
41. It is important to note that the conception of autonomy interests and well-being interests in the Nuffield Council on Bioethics Report, above, n 14, para 2.25-2.39, is tailored specifically to the practical ethical dilemmas that arise in dementia care. It will of course be the case that different conceptions of autonomy interests and well-being interests will be required to frame the ethical dilemmas that arise in both comparable situations (e.g. the need to make decisions on behalf of adults with learning disabilities, or those in a persistent vegetative state), and other areas of health and social care practice.
42. This argument forms part of a critical ethical analysis of the Mental Capacity Act 2005's best interests criteria in the context of dementia care
43. T Hope, A Slowther and J Eccles, 'Best Interests, Dementia, and the Mental Capacity Act 2005' (2009) 35 J Med Ethics 733
44. S Holm and A Edgar, 'Best Interest: A Philosophical Critique' (2008) 16 Health Care Anal 197
45. S McGuinness, 'Best Interests and Pragmatism' (2008) 16 Health Care Anal 208