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1
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78651238842
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Penguin, London, reprinted 1978
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Lawrence TE. The Mint. Penguin, London 1955, reprinted 1978
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(1955)
The Mint
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Lawrence, T.E.1
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2
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84992857215
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(a) the patient is unable to comprehend and retain the information which is material to the decision, especially as to the likely consequences of having or not having the treatment in question; (b) the patient is unable to use the information and weigh it in the balance as part of the process of arriving at the decision.
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Re MB 8 Med LR 217, 224, CA per Butler-Sloss, LJ. When the Mental Capacity Act comes into force, in 2007, under 3 a person will not be able to consent to or refuse treatment if they cannot (a) understand the information relevant to the decision, (b) retain that information, (c) use or weigh it as part of the process of making the decision, or (d) communicate their decision.
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The legal test for competence is: ‘(a) the patient is unable to comprehend and retain the information which is material to the decision, especially as to the likely consequences of having or not having the treatment in question; (b) the patient is unable to use the information and weigh it in the balance as part of the process of arriving at the decision.’ Re MB [1997] 8 Med LR 217, 224, CA per Butler-Sloss, LJ. When the Mental Capacity Act 2005 comes into force, in 2007, under 3 a person will not be able to consent to or refuse treatment if they cannot (a) understand the information relevant to the decision, (b) retain that information, (c) use or weigh it as part of the process of making the decision, or (d) communicate their decision.
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(2005)
The legal test for competence is
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8
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85051616237
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The Latest Decalogue; as cited in Glover J.
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Penguin, London
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Clough AH. The Latest Decalogue; as cited in Glover J. Causing Death and Saving Lives. Penguin, London, 1977: 92
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(1977)
Causing Death and Saving Lives
, pp. 92
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Clough, A.H.1
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13
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84992773241
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You should bear in mind that you are bound to respect an adult patient's competently made refusal of treatment even where complying with the decisions will lead to the patient's death. If a specific treatment is requested which, in your considered view is clinically inappropriate, you are not legally or ethically bound to provide it. However, you should give the patient a clear explanation of the reasons for your view, and respect their request to have a second opinion.
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GMC, n 3 above, para 42.
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GMC, n 3 above, para 42. ‘You should bear in mind that you are bound to respect an adult patient's competently made refusal of treatment even where complying with the decisions will lead to the patient's death. If a specific treatment is requested which, in your considered view is clinically inappropriate, you are not legally or ethically bound to provide it. However, you should give the patient a clear explanation of the reasons for your view, and respect their request to have a second opinion.’
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14
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84992773242
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Where the possibility of withholding or withdrawing a life-prolonging treatment is an option, you should offer the patient the opportunity to discuss how their care would be managed if such a decision were made. This should include: arrangements for providing nursing care and other appropriate treatments; the patient's preference about who should be involved in decisionmaking or in providing additional support if they become incapacitated; what might be their palliative or terminal care needs should death become inevitable and how would these be met.
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GMC, n 3 above, para 43.
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GMC, n 3 above, para 43. ‘Where the possibility of withholding or withdrawing a life-prolonging treatment is an option, you should offer the patient the opportunity to discuss how their care would be managed if such a decision were made. This should include: arrangements for providing nursing care and other appropriate treatments; the patient's preference about who should be involved in decisionmaking or in providing additional support if they become incapacitated; what might be their palliative or terminal care needs should death become inevitable and how would these be met.’
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15
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84992801317
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4 All ER 649 and the recent debate over the prophylactic use of Herceptin
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For example Re T (Adult: Refusal of Medical Treatment) [1992] 4 All ER 649 and the recent debate over the prophylactic use of Herceptin
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(1992)
For example Re T (Adult: Refusal of Medical Treatment)
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16
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84992763401
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Discussions of this kind may need to be conducted over several meetings. You should hold discussions at a time when the patient is best able to understand and retain information. You should allow the patient sufficient time to reflect and ask questions before deciding, and discuss the patient's right to change their mind about the decision.
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GMC, n 3 above, para 45.
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GMC, n 3 above, para 45. ‘Discussions of this kind may need to be conducted over several meetings. You should hold discussions at a time when the patient is best able to understand and retain information. You should allow the patient sufficient time to reflect and ask questions before deciding, and discuss the patient's right to change their mind about the decision.’
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