Coggon John
University of Bristol Law School, Bristol, UK.
Med Law Rev. 2016 Summer;24(3):396-414. doi: 10.1093/medlaw/fww034.
This article examines medical decision-making, arguing that the law, properly understood, requires where possible that equal weight be given to the wishes, feelings, beliefs, and values of patients who have, and patients who are deemed to lack, decision-making capacity. It responds critically to dominant lines of reasoning that are advanced and applied in the Court of Protection, and suggests that for patient-centred practice to be achieved, we do not need to revise the law, but do need to ensure robust interpretation and application of the law. The argument is based on conceptual analysis of the law's framing of patients and medical decisions, and legal analysis of evolving and contemporary norms governing the best interests standard.
本文探讨了医疗决策,认为如果正确理解法律,那么在可能的情况下,法律要求对具有决策能力的患者和被认为缺乏决策能力的患者的意愿、感受、信仰和价值观给予同等重视。它对保护法庭中提出并应用的主流推理思路进行了批判性回应,并表明要实现以患者为中心的实践,我们不需要修改法律,但需要确保对法律进行有力的解释和应用。这一论点基于对法律对患者和医疗决策的框架的概念分析,以及对适用于最佳利益标准的不断演变的当代规范的法律分析。