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Advance decision making – rhetoric or reality?

Published online by Cambridge University Press:  02 January 2018

Carolyn Johnston
Carolyn Johnston*
Affiliation:
Kingston University; King's College London
*
Dr Carolyn Johnston, Senior Lecturer in Law, Faculty of Business and Law, Kingston University, 47 Kenry House, Kingston Hill, Kingston upon Thames KT2 7LB, UK. Email: [email protected]; Adviser, Medical Law & Ethics, King's College London, School of Medicine, 4.18 Shepherd's House, Guy's Campus, London SE1 9RT, UK. Email: [email protected]
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Abstract

The Mental Capacity Act 2005 introduced a statutory framework for advance decisions, thus promoting autonomous healthcare decision making in advance of loss of capacity. In order to be valid and applicable, and so binding on healthcare professionals, advance decisions refusing treatment (ADRT) must specify treatments to be refused and the circumstances of refusal. Recent case-law indicates that a high level of specificity is required for advance refusals of life-sustaining treatment and, in contrast to a presumption of capacity for contemporaneous decisions, in some circumstances capacity must be demonstrated at the time of making the advance decision. In comparison with the ‘stringent’ requirements for ADRT, the more generic Advance Care Planning (ACP) is gaining more prominence in end of life decision making. The paper explores recent case-law and its impact on the effectiveness of ADRT in practice and compares with ACP.

Type
Research Article
Information
Legal Studies , Volume 34 , Issue 3 , September 2014 , pp. 497 - 514
Copyright
Copyright © Society of Legal Scholars 2014

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