- Title Pages
- Editors’ Preface
- Notes on Contributors
- Table of Cases
- Table of Statutes, Conventions, ETC
- The NHS in Private Hands? Regulating Private Providers of NHS Services
- Health Care Information Technology and Provider Accountability: A Symbiotic Relationship
- The Manipulation of Medical Practice
- Clinical Guidelines, Negligence and Medical Practice
- Threatening Behaviour? The Challenge Posed by Medical Negligence Claims
- Information, Decisions, and the Limits of Informed Consent
- Patient Autonomy—A Turn in the Tide?
- Legal Limits: When does Autonomy in Health Care Prevail?
- Law, Society, and the New Genetics
- <b>The Ethics of Human Cloning</b>
- Written in Code: Diversity and the New Genetics
- Gene Therapy—Cure or Challenge?
- Protecting the Unborn Child from its Drug or Alcohol Abusing Mother
- Status of the Embryo in the Light of Islamic Jurisprudence
- Can We Leave the Best Interests of Very Sick Children to their Parents?
- The Caesarean Section Cases and the Supremacy of Autonomy
- Policing Pregnancy: Rights and Wrongs
- The Gifts of Life-Donating Gametes and the Consequences
- Consent and Intent: The Legal Differences in Assisted Reproductive Treatments
- Symbolic Harm and Reproductive Practices
- Viagra is Coming! the Rhetoric of Choice and Need
- The Politics of Paternity: Foetal Risks and Reproductive Harm
- Research on Human Subjects, Exploitation, and Global Principles of Ethics
- Government Priorities for Biomedical Research: What Does Justice Require?
- Health Research with Children: the New Zealand Experience
- Medical Data, New Information Technologies, and the Need for Normative Principles Other than Privacy Rules
- Pre-Employment Health Screening
- Human Organ Transplant Ordinance: Facilitating Adult Live Donor Transplants?
- Thrift-Euthanasia, in Theory and in Practice: A Critique of Non-Heart-Beating Organ Harvesting
- The Comatose Pregnant Woman: Abortion and the Substituted-Judgement Approach
- The Mental Health Act: Taking Stock of the Current Position and Thinking about the Future
- Mind and Body: Medicine and Law
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
- 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.
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