什么是“最佳利益”？对临床实践中“最佳利益”决策的批判性评估。
WHAT ARE 'BEST INTERESTS'? A CRITICAL EVALUATION OF 'BEST INTERESTS' DECISION-MAKING IN CLINICAL PRACTICE.
作者信息
Taylor Helen J
机构信息
Applied Professional Studies, Institute of Health and Society, University of Worcester, Henwick Grove, Worcester WR2 6AJ, UK
出版信息
Med Law Rev. 2016 Spring;24(2):176-205. doi: 10.1093/medlaw/fww007. Epub 2016 Mar 14.
Obtaining the patient's consent is usually a prerequisite of any clinical intervention. However, some cognitively impaired patients may not be able to give valid consent. Following years of consultation and legislative review, the Mental Capacity Act 2005 (MCA) provides a statutory framework of 'best interests' decision-making on behalf of incapacitated individuals. However, confusion over the meaning and application of the 'best interests' standard persists. This paper explores the variation in judicial interpretation of the standard and the complexities of best interests decision-making in clinical practice. Prevailing confusion and risk-aversive practices mean that the rights and interests of cognitively impaired individuals continue to be compromised, with evidence to suggest that 'best interests' may be conflated with the clinician's evaluation of 'best medical interests'.
获得患者的同意通常是任何临床干预的前提条件。然而，一些认知受损的患者可能无法给出有效的同意。经过多年的咨询和立法审查，2005年《精神能力法案》（MCA）提供了一个法定框架，用于代表无行为能力的个人做出“最佳利益”决策。然而，对于“最佳利益”标准的含义和应用仍存在困惑。本文探讨了该标准司法解释的差异以及临床实践中最佳利益决策的复杂性。普遍存在的困惑和规避风险的做法意味着认知受损个体的权益继续受到损害，有证据表明“最佳利益”可能与临床医生对“最佳医疗利益”的评估混为一谈。
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