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Volume 13, Issue 1, Pages 57-60 (February 2003)


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Patient competence and medical persuasion

Martin G.F Lupton (Perinatal Fellow)f1

Abstract 

Patients are autonomous beings and may make choices that, to their doctor, are completely bewildering. While a doctor has both a legal and moral duty of care for his/her patients, a patient may refuse any treatment for any reason. The law manifests its respect for the principle of autonomy through the concept of consent. However, for patients to exercise their right to consent they must first be deemed to be competent. Incompetent patients can be treated in their best interests, as determined by their doctor. Competent patients may determine what their best interests are and what treatment they will allow. A doctor may try and persuade a competent patient to change his/her mind but may not coerce that patient. A doctor is less likely to infringe a patient's autonomy if they know that patient well and understand the critical elements of that patient's life plan.

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FURTHER READING

1. 1 Berlin I. Four Essays on Liberty. Oxford: Oxford University Press; 1969;.

2. 2 Daniels N. Just Health Care. Cambridge: Cambridge University Press; 1985;.

3. 3 Reference Guide to Consent for Examination or Treatment. London: HMSO; 2001;.

4. 4 Dworkin G. The Theory and Practice of Autonomy. Cambridge: Cambridge Universtity Press; 1988;.

5. 5 Kennedy I, Grubb A. Medical Law (text with materials). London: Butterworths; 1998;.

6. 6 Kenny A. A Brief History of Western Philosophy. Oxford: Blackwell; 1998;.

7. 7 Malette v, Shulman, 1990

8. 8 Mason JK, McCall-Smith RA. Law and Medical Ethics. London: Butterworths; 1999;.

9. 9 Re, J, 1992

10. 10 Re, M. B. 1997

11. 11 Scott R. Rights, Duties and the Body: Law and Ethics of the Maternal–Fetal Conflict. Oxford: Hart Publishing; 2002;.

12. 12 Wilson P. Ethical debate: legal issues. Br Med J. 1995;311:116–117.

The Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK

f1 Correspondence to: MGFL. Tel.: 0208 746 8000 ext 8932; E-mail: martin@glupton.fsnet.co

PII: S0957-5847(03)90308-8

doi:10.1054/cuog.2003.0308


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