Autonomy, Informed Consent and Medical Law: A Relational Challenge

Half-title......Page 3
Series-title......Page 4
Title......Page 7
Copyright......Page 8
Contents......Page 11
Table of cases......Page 12
Figures......Page 18
Acknowledgements......Page 19
Introduction......Page 21
Part I: An ethical model......Page 27
The nature of autonomy......Page 29
Autonomy as self-determination......Page 31
Autonomy as rational self-determination......Page 33
Autonomy as moral rational self-determination......Page 37
The value of autonomy......Page 43
The limits of autonomy......Page 49
The harm principle......Page 50
Other limiting principles......Page 53
The protection of future autonomy......Page 56
Future selves......Page 58
Autonomy as the moral basis for consent......Page 61
Conclusion......Page 65
2 The relevance of beneficence, justice and virtue......Page 68
Beneficence......Page 69
Paternalism......Page 71
The role of justice......Page 77
Justice and respect for autonomy......Page 79
Justice, resources and support for autonomy......Page 81
Justice and responsibility for outcome......Page 83
The relevance of virtue......Page 87
Conclusion......Page 90
3 The healthcare professional-patient relationship: Setting the context for consent......Page 92
The professional-patient relationship......Page 93
The professional\'s obligations within the professional-patient relationship......Page 99
The patient\'s obligations within the professional-patient relationship......Page 113
The patient\'s obligations and mandatory autonomy......Page 117
The virtuous patient......Page 121
The virtue of professionalism and the professional virtues......Page 122
External factors......Page 125
Conclusion......Page 128
A preliminary definition......Page 130
The nature and function of consent to medical treatment......Page 133
Consent as a process......Page 142
Consent as a choice......Page 144
Consent and non-treatment......Page 147
Consent and shared decision-making......Page 149
Consent and refusal: two sides of the same coin?......Page 150
Consent, power and control......Page 153
Consent, information, knowledge and risk......Page 154
Consent and voluntariness......Page 159
Consent and competence......Page 160
Conclusion......Page 162
Addendum......Page 163
Part II: Consent and the law......Page 167
5 The legal regulation of consent......Page 169
Battery......Page 170
Consent and battery......Page 173
Competence......Page 174
Voluntary consent......Page 176
Real consent......Page 179
The legal regulation of consent in negligence......Page 182
The facts and judgments......Page 183
Sidaway and the standard of care......Page 187
Answering questions......Page 188
Pre-Bolitho......Page 189
Bolitho, beyond Bolam?......Page 192
Information disclosure and understanding......Page 197
The professional\'s duty to persuade......Page 200
Non-treatment decisions......Page 202
Disclosure and causation......Page 203
The nature of the test......Page 204
The content of the test......Page 207
Legally recognised damage......Page 208
Conclusion......Page 210
The split between battery and negligence......Page 211
Consent and negligence......Page 216
The problem of treatment refusal......Page 229
The problem of non-treatment decisions......Page 232
The problems of the common law......Page 234
Addressing the gap between practice and principle......Page 237
Conclusion......Page 238
The developing law......Page 240
The cycle of criticism and the scope for further development......Page 241
The nature of healthcare delivery......Page 245
Manson and O\'Neill\'s model of genuine consent......Page 246
The relational model of consent......Page 251
Implementing relational consent......Page 253
The proposed principles......Page 254
Fleshing out the principles......Page 257
Regulating the process......Page 261
The obligation to facilitate understanding and good decision-making......Page 266
Information disclosure - measuring the outcome......Page 270
Exceptions......Page 273
The effect of consent......Page 275
Refusal of consent......Page 277
Liabilities and remedies......Page 278
Summary and conclusion......Page 280
Bibliography......Page 290
Index......Page 310