Medical Treatment: Decisions and the Law

3. Deciding for Others – Adults

Co-authored by Nageena Khalique QC and Rachael Gourley.

Contents

  • A The court’s jurisdiction 3.1
  • The historical context 3.2
  • B General rules  3.3
  • General rule 1: A capable adult’s wishes must be respected 3.3
  • Exception: Mental Health Act 1983, s 63 3.4
  • Case law on the MHA  3.5
  • General rule 2: There is only limited proxy of consent for others 3.9
  • General rule 3: There is a power under the MCA to treat in an incapacitous person’s best interests 3.10
  • Doctrine of necessity 3.11
  • C Decision making for adults under the MCA 3.12
  • Principles 3.12
  • Determination of best interests – overview 3.13
  • Holistic/wider best interests 3.14
  • ‘Analysis of Competing Issues’  3.15
  • The focus on the patient 3.18
  • P’s wishes and feelings, beliefs and values 3.21
  • Independent Mental Capacity Advocates 3.22
  • Consultation with other people 3.23
  • DNAR Notices  3.24
  • Sharing information 3.25
  • Interests of others 3.26
  • Financial interests 3.27
  • Experimental and controversial treatment 3.28
  • End of life – intolerability and dignity 3.29
  • The sanctity of life – a starting point 3.30
  • Advance decisions 3.31
  • Scope of power to treat  3.32
  • The power of the Court of Protection to consent to treatment 3.33
  • Covert administration of medication and deceit 3.34
  • Deception and P’s Article 8 rights  3.36
  • Covert insertion of contraceptive devices?  3.37
  • Does P need to be told he has been covertly medicated? 3.38
  • Covid-19 vaccination case law 3.39
  • Where vaccination not in P’s best interests 3.40
  • ‘Booster’ shots 3.41
  • D The court’s powers under its inherent jurisdiction relating to vulnerable adults 3.42
  • E Conclusion  3.45
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