Every adult is presumed to have the capacity to decide whether or not to consent to proposed medical intervention, unless they cannot understand information presented in a clear way. Capacity should not be confused with the reasonableness of the patient's decision however irrational it seems. A voluntary and informed decision by a competent adult to refuse treatment must be respected whatever the outcome for mother or child. This article considers the continuing implications of this is in light of the breakdown of the implicit compact between doctors, patients and society.
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