Could the values or value system of a competent person, disclosed in a living will, play a role in medical treatment decision-making processes under the Mental Capacity Act 2005?
Disclosing a value system in a living will could be in your best interests: Whilst doctors are recognised for being expert in medical matters they are nevertheless generally required by law to obtain the consent of a competent adult patient prior to administering a medical treatment.1 The need for consent underpins the right of a competent adult patient to refuse treatment, even life preserving treatment. Accordingly, bodily inviolability is a fundamental principle of law and violation of it, even for benevolent reasons, is prima facie punishable. Instead of which a competent patient has a right to self-determine what shall happen to their own body. In this way the subjective decision-making standards and methods of a competent patient inform, and are made determinative, of any decision to accept or reject a medical treatment. It is against this general background that the comments of Lord Goff in the case of Bland should be considered. There he suggested that the best interests test should comprise of something more than purely professional appraisal of a person’s medical welfare.2 To confine the test in this way, he said, would be inconsistent with the primacy given to the principle of self-determination and would ‘downgrade the status of the incompetent person by placing a lesser value on [their] intrinsic worth and vitality’.3 So as the title to this thesis suggests I am primarily concerned with legal provisions governing medical treatment decision-making processes in respect of formerly competent adult patients. More specifically it questions whether the values, beliefs and preferences of members of this patient group should be more favourably promoted, i.e. used and made determinative, in medical treatment decision-making processes concerning them based on contemporary understanding and application of the moral principle of autonomy
