Protecting the Vulnerable: Autonomy and Consent in Health Care (Social Ethics and Policy)

Protecting the Vulnerable explores the reality of patient control and choice in health care and analyzes how decisions should be made on behalf of those deemed incapable of making decisions. The contributors--distinguished experts from the disciplines of medicine, ethics, theology, and law-- look at the complex problem of autonomy and consent in health care and clinical research today from an illuminating perspective: its impact on the vulnerable members of society. Introduction -- Without Their Consent?: Working With Very Premature Babies / Colin Morley -- The Ethics Of Research With Children / Richard Nicholson -- Competence And Consent In People With Mental Handicap / Peter Mittler -- Competence, Consent And Proxy Consents / Margaret Brazier -- Research On The Vulnerable: An Ethical Overview / Raanan Gillon -- Sterilization Abuse: Women And Consent To Treatment / Heather Draper -- Dependency Revisited: The Limits Of Autonomy In Medical Ethics / Alastair Campbell -- Suicide And Justified Paternalism / Gavin Fairbairn -- Informed Consent And The Ghost Of Bolam / Richard Lindley -- The Patient's Right To Information / Harry Lesser -- Student Problems And Problem Students: A Vulnerable Group? / Mary Lobjoit. Edited By Margaret Brazier And Mary Lobjoit. Includes Bibliographical References (p. 176-178) And Index. Book Cover......Page 1 Title......Page 4 Contents......Page 6 Notes on contributors......Page 8 Preface......Page 10 Introduction......Page 12 WITHOUT THEIR CONSENT? WORKING WITH VERY PREMATURE BABIES......Page 16 THE ETHICS OF RESEARCH WITH CHILDREN......Page 22 COMPETENCE AND CONSENT IN PEOPLE WITH MENTAL HANDICAP......Page 34 COMPETENCE, CONSENT AND PROXY CONSENTS......Page 46 RESEARCH ON THE VULNERABLE: AN ETHICAL OVERVIEW......Page 64 STERILIZATION ABUSE: WOMEN AND CONSENT TO TREATMENT......Page 88 DEPENDENCY REVISITED: THE LIMITS OF AUTONOMY IN MEDICAL ETHICS......Page 112 SUICIDE AND JUSTIFIED PATERNALISM......Page 124 INFORMED CONSENT AND THE GHOST OF BOLAM......Page 146 THE PATIENT'S RIGHT TO INFORMATION......Page 162 STUDENT PROBLEMS AND PROBLEM STUDENTS: A VULNERABLE GROUP?......Page 174 Bibliography......Page 190 Index......Page 194 Humanities Book Cover 1 Title 4 Contents 6 Notes on contributors 8 Preface 10 Acknowledgements 12 Introduction 12 WITHOUT THEIR CONSENT? WORKING WITH VERY PREMATURE BABIES 16 THE ETHICS OF RESEARCH WITH CHILDREN 22 COMPETENCE AND CONSENT IN PEOPLE WITH MENTAL HANDICAP 34 COMPETENCE, CONSENT AND PROXY CONSENTS 46 RESEARCH ON THE VULNERABLE: AN ETHICAL OVERVIEW 64 STERILIZATION ABUSE: WOMEN AND CONSENT TO TREATMENT 88 DEPENDENCY REVISITED: THE LIMITS OF AUTONOMY IN MEDICAL ETHICS 112 SUICIDE AND JUSTIFIED PATERNALISM 124 INFORMED CONSENT AND THE GHOST OF BOLAM 146 THE PATIENT'S RIGHT TO INFORMATION 162 STUDENT PROBLEMS AND PROBLEM STUDENTS: A VULNERABLE GROUP? 174 Bibliography 190 Index 194 The right of adults with sound mind to consent to treatment or risk their own health for the benefit of the community in a clinical trial is unequivocally recognised by the law. But what about those vulnerable by virtue of their age, nature or position in society? Experts from the fields of medicine, philosophy, theology and law, explore the ethical and legal principles which seek to reconcile the individual's right to autonomy with the need to protect vulnerable groups. Discussions refer both to specific groups (premature babies, children, people with mental handicaps) and specific issues (cases of abuse by sterilization of women, suicide, the right to information). A collection of essays that discuss, within medical practice, the ethical problems thrown up by the conflict between the individual's right to autonomy and the need to protect the interests of vulnerable groups such as the mentally handicapped or premature babies