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Law and MedicineCurrent Legal Issues Volume 3$
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Michael Freeman and Andrew Lewis

Print publication date: 2000

Print ISBN-13: 9780198299189

Published to Oxford Scholarship Online: March 2012

DOI: 10.1093/acprof:oso/9780198299189.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (www.oxfordscholarship.com). (c) Copyright Oxford University Press, 2019. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 22 November 2019

Patient Autonomy—A Turn in the Tide?

Patient Autonomy—A Turn in the Tide?

(p.127) Patient Autonomy—A Turn in the Tide?
Law and Medicine

Rebecca Bailey-Harris

Oxford University Press

The genesis of this chapter was the decision of the Court of Appeal in St George’s Healthcare NHS Trust v. S; R. v. Collins and Others, ex parte S. The decision under consideration here highlights a number of classic debates in medical ethics: autonomy versus paternalism, consequentialism versus deontological absolutism, and the nature of personhood. The particular factual context was that of refusal of medical and surgical treatment by a woman in a late state of pregnancy, but the decision is of a wider significance. The decision is concerned primarily with the power of the patient against the medical profession, rather than any conflict between mother and unborn child. This interpretation is based on three particular aspects of the judgment: the absolute nature of the autonomy right as framed by the Court of Appeal and its contextualization as a necessary freedom within a democratic society which will brook no erosion; the reasoning technique which denies the foetus the status of personhood, and thus deliberately eschews a conflict of rights analysis; and the issuing by the court of guidelines which are intended, at least procedurally, to tip the balance back in favour of the competent patient in future situations. The decision represents a landmark for patient autonomy generally.

Keywords:   medical ethics, patient autonomy, personhood, unborn child, paternalism, deontological absolutism

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