mental incapacity, disability and rights Flashcards
what do we mean by a right *
rights are a special form of moral claim - legal or moral rights
legal right - line in law that allows things to happen
moral - because i am a person i have rights
should 2 identical patients other than their nationalities have different positions on the transplant list
no - the decision should be done solely on medical info
should a pt with downs have the same chance of a transplant as a healthy pt when both would have the same survival rates
yes - the person with downs has the same right as everyone else
no - perhaps less compliant post-op, argue that their life is less valuable so less worth saving
what counts as a right *
who decides
we all agree basic rights not to be killed or tortured
however - we do kill people who are a threat
there is no consensus that rights exist or whether they are rhetorical tools
what are negative and positive rights and examples *
negative - about what people may not do to us eg kill, injure or steal
positive - what others must provide for us - education, autonomy, healthcare
positive rights are redundant in a society without the resources to fund it
examples of how far positive rights could go *
right to housing
welfare
fertility treatment - if right to healthcare, why is this not included
right to good physical and mental health
what is the problem with having rights *
it means that it is someone elses’ duty to provide those things - especially positive rights eg healthcare
also - are rights more certified than just things that people want
without the institutions to deliver health they are more like an empty entitlement or aspiration
if a person (X) with a mental age of 2 is the only bone marrow match for her sister, should she be used to take the marrow
when she sees her sister it brings her joy but this is infrequent *
consequentialist argument - yes - cause more benefit than harm so should be done. However, then could arguably take from anyone who is a match
rights protect vulnerable people from utilitarianism
X has the same rights as her sister - so the operation should only be done if it benefits her
X has a right to freedom from harm - she would be given pain and not be able to understand why
X has a right to freedom from interference - bodily integrity
welfare of the family - if X doesnt give marrow and eldest sister dies - mum will have to look after oldest sister’s child and will be less able to look aftyer X
how do we decide what the best interests are for patients w/o capacity *
burden of treatment
prognosis
alturism - if dont have the capacity to be alturistic then can you argue that it is in someones best interest
QOL - subjective
osychological impact
expressed wishes - get feeling overall if they want treatment
welfare of family
previously expressed wishes
individual rights
what are previously expressed wishes *
what is said now affects the future decisions made about you
what is the precedent right to decide *
if a person loses autonomy through acquired mental disability, eg head injury/dementia should there be a precedent right (when autonomous) to determine future treatment or non-treatment
how do advanced decisions fit into the mental capacity act *
advance decisions drawn up when an individual is mentally competant are legally binding
it follows that there is a legal right to rrefuse treatment if mental capacity is lost ion the future
describe Margo’s logo *
person see pt with dementia - always read book upside down
seemed happy
describe Ronald Dworkin’s view on precedent *
need to consider the interests of a person who has become demented - not just the person who is demented
critical interests include being able to shape how our lives go on as a whole
to deny the right to determine the manner of our death would violate our respect for autonomy
describe Rebecca Dresser’s view on precedent *
it is difficult for people to make decisions about something they dont know about
there is ni opportunity to discuss any changes in treatment that may come about eg if new treatment comes available
the person who has become demented may be a different person prior to the dementia - they have no recollection of the past
minimally invasive treatment should be administered irrespective of an AD if the person appears content and active
what are the legal grounds for abortion *
it is a criminal offence unless
- the pregnancy is <24weeks and the risks to the physical and mental health of the women or children in her family are greater if the pregnancy continued
- at any stage if
- it is to prevent grave and permenant injury to the mother
- continuing preg would involve a greater risk to the life of a pregnant women than the termination would (pregnancy is generally mroe risky than abortion)
- substantial risk of serious physical or mental handicap
what are the rights regarding abortion and disability*
an abortion can be performed at any stage on the grounds of serious disability
few conditions are so awful that people sya that they are better off dead
downs syndrome accounts for 20% of the aboritions performed on the grounds of a serious handicap
does the current law imply that those with a disability have a lesser claim on the right to life
ethical issues regarding abortion and disability *
it is arguing that because people suffer they wopuld be better off having not been born - however people with a disability seem to live a fulfilled life
also by aborting we say that the people alive with these conditions have less fulfilling lives
is it different than terminating the baby based on sex or hair colour
do they reinforce prejudice against those with a disability
is disability a social construct *
arguably disability is only a problem because society fails to support those with a disability
parents of people with disabilities are more concerned about the social stigma than the physical limitations
parents worry about who will look after their child when they die
how does disability affect maternal rights *
reality of a disabled child is that it puts immentse physical, emotional and financial strain on parents
other children in family might suffer as a result of this
therefore a women should have the right to choose to terminate
how does having a disabled foetus affect autonomy *
as moral agents mothers should make morally acceptible decisions
autonomous decisions should be respected as long as they are morally acceptible
autonomous choice requires that we are given a reasonable range of options
if society fails to ensure justice and provide an adequate level of support for those with disability, does a women have a reasonable choice of options and therefore does she have true autonomy
has the law around abortion and disability got it wrong *
is it discriminatory
has the law on advanced decisions got it wrong *
is there too much weight on precedent autonomy
what is the relationship between law and ethics *
in liberal democrats, not all that is considered immoral is illegal
nor everything that is unlawful is unethical
therefore the law might mot be the best way to promote ethical behaviour
describe alec bourne’s effect on the law *
he was a gynaechologist
aborted a girl age 14 who had been raped at a time when it was legal only to save the mothers life
he argued that aborting this child saved the life of the girl who had been raped
laws changed becasue at this point the law was unethical
role of drs with the law *
we must work with the law, but also be critical of it
