Autonomy & Best Interests Flashcards
What’s the relationship between autonomy and capacity?
Capacity is a legal concept
Autonomy is an ethical concept
If someone lacks capacity for a decision their autonomy can still be respected
What are some theories about how we should value autonomy?
Mill: instrumental autonomy Kant: intrinsic autonomy Libertarianism: priority of autonomy Negative duty: respect autonomy Positive duty: promote autonomy
What’s the ulysses contract?
Short term restrictions on autonomy may enhance autonomy in the long term
Consequentialism vs deontology
What’s the legal requirement to respect autonomy?
Treatment without consent is battery (common law)
MCA: a person isn’t to be treated as unable to make a decision unless all practicable steps have been taken without success first
What’s the duty of care?
To respect autonomy
To act in a patients best interest
To prevent a patient from harm
Outline the respecting autonomy principle of the duty of care
Treat patients as individuals and respect right to reach own decisions
If an adult has capacity their autonomous decision must be respected, even if it results in harm
Outline the best interests principle of the duty of care
Mental state: what brings the most happiness
Desire fulfilment - linked to autonomous choices
Objective list - set of agreed criteria for achieving wellbeing (eg independence, meaningful relationships)
Under the MCA what are the 3 key things you should consider in best interests decision?
Persons past and present wishes and feeling
Beliefs and values likely to influence decision if had capacity to do so
Other factors person would be likely to consider if they were able to do so
Outline the protecting a patient from harm principle of best interest decisions
When considering restraint or deprivation of liberty, you need to consider:
The harm that will occur if you don’t restrain
The physical and psychological harm from restraint
Minimum level of restraint required
The proportionality of the restraint and benefit to treatment
Which two principles come into conflict when restraining someone?
Duty to protect from harm and respect their autonomy
What’s the legal framework for restraint and deprivation of liberty?
Short term - MCA
Long term - DOLS
What are the criteria adults must meet for safeguarding protection?
Has care and support needs
+ is experiencing or is at risk of abuse
+ is unable to protect themselves because of needs
What should you do if you suspect someone is a safeguarding risk?
Identify adults who have safeguarding needs Respond to immediate risks Assess individuals ongoing needs Assess capacity Identify relevant services Seek consent Review
