"At Long Last The English Courts Now Recognise And Endorse Patient Autonomy" Discuss.

2766 words - 11 pages

In relation to health care law the principle patient autonomy entails taking into account and giving consideration to the patient's views of their treatment.Autonomy was first recognised as a relevant ethical principle to be endorsed by the courts in relation to heath care law by Mr Justice Cardozo in America and later affirmed in the English courts by Lord Donaldson; "An adult patient who suffers from no mental incapacity has an absolute right to choose whether to consent to medical treatment, to refuse it, or to choose one rather than another of the treatments being offered...This right of choice is not limited to decisions which others might regard as sensible. It exists notwithstanding that the reasons for making the choice are rational, irrational, unknown or even non-existent" .A patient's right to autonomy pivots on the consent to treatment they give; consent is a method of autonomy. This relationship was defined by Lord Goff; "First, it is established that the principle of self-determination requires that respect must be given to the wishes of the patient, so that, if an adult patient of sound mind refuses, however unreasonably, to consent to treatment of care by which his life would or might be prolonged, the doctors responsible for his care must give effect to his wishes, even though they do not consider it to be in his best interests to do so...To this extent, the principle of the sanctity of human life must yield to the principle of self-determination: and for present purposes perhaps more important, the doctor's duty to act in the best interests of his patient must likewise be qualified"Consent can be given both expressly or impliedly. If consent is not given for a specific action performed by a doctor on his patient then this can constitute a battery. It is also viable that an action in negligence can be initiated; where there has been a breach of the duty of care owed to the plaintiff. The test in Bolam defines the essence of medical negligence and states that "a doctor is not negligent if he acts in accordance with a practice accepted at the time as proper by a responsible body of medical opinion."For consent to be valid there are three considerations; was the consent sufficiently informed? Was the patient competent to consent? Was the consent uncoerced?With regard to the amount of information a patient should be expected to receive it was established in the case of Chatterton v. Gerson that "once that patient is informed in broad terms of the nature of the procedure which is intended, and gives her consent, that consent is real" . However, it is the 'seminal' case of Sidaway that redefined that decision. It concerned a woman who had had an operation but had continued pain and so was advised of a second operation. She consented and proceeded with the operation but as a result became severely disabled by partial paralysis. She sued both the doctor and the hospital for not informing her of two specific risks over and above the risk...

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