Medical Decision Making: Ethics and Law

In this first unit we introduce what we mean by ethics and explore the relationship between ethics and law.  We then move on to what it means to ‘do' ethics in the context of healthcare and start to examine some ethical questions and case studies.  Students are walked through some of the theoretical approaches used in ethics and introduced to a way of critical thinking that will help them to deal with ethical questions (where there might not be a clear right or wrong answer) and come to a position on these questions that they can be confident about holding.  

This second unit starts off by explaining the basics of the English legal system and the principal sources of law in the English Legal system.  We explain what is meant by case law, statutes, and international law and what role they play in the English legal system. We also provide you an optional opportunity to develop skills in finding and reading case law and understanding legal terminology.  

This third unit explores the central ethical and legal importance of the principle of respect for individual autonomy to medical/healthcare decision-making.

We explain what is meant by this principle of respect for individual autonomy, why this principle is seen as so ethically important, and what it means to respect this principle. 

We then explore how this ethical principle contrasts with medical/healthcare paternalism and how respect for individual autonomy is the foundation for current approaches to legal consent to treatment. You'll get further opportunities to develop your skills in analysing and developing ethical arguments in relation to real-life cases and ethical questions.  

In Unit 4 of this package, you'll explore what is meant by valid legal consent. You'll learn that consent may be written, verbal, or implied and will start to understand what is needed for consent to be considered legally valid. You'll also explore the legal consequences of treating patients without their valid legal consent in both the torts of battery and negligence.  There are opportunities within this Unit for you to relate your learning to real-world and hypothetical cases.

In Unit 4 we explored the notion of valid legal consent and understood that for consent to be valid, it needs to be sufficiently informed. In this Unit we explore how much and what kind of information should be provided for consent to be valid.  In order to do this, we explore legal precedent in this area to understand how guidance in this area has evolved and how the standard for information needed for informed consent has moved from a ‘professional standard’ towards a ‘prudent patient standard’.  We then outline the current English Law in this area in detail and the General Medical Council and British Medical Association guidance around information and informed consent. There are opportunities within this Unit for you to relate your learning to real-world and hypothetical cases.

In order to provide valid legal consent a patient must have the mental capacity to do so.  In this Unit we explain what is meant by having capacity to make decisions in healthcare settings including how the law determines capacity.  You'll understand how capacity can be assessed in line with current legal guidance through case studies presented to apply this to practical scenarios.  We also provide guidance on treating adults who lack the capacity to consent to medical treatment.

In this Unit we explore the main ethical and legal issues surrounding refusal and withdrawal of medical treatment.  Students will gain understanding of the legal right to refuse medical treatment and its relationship with establishing patient competence.  In addition, we explore the use of Advance Directives and present the current legal guidance on childbirth and refusal of treatment. There are opportunities throughout this Unit to reflect on real-life and hypothetical cases in this area including an opportunity to draft your own Advance Directive if you wish to do so.

In this Unit we explore the ethical and legal issues surrounding the treatment of neonates, children and adolescents.  We start by exploring parenthood to understand what is meant by biological/genetic, social and legal parenthood with parental responsibility. 

We explore the scope of parental responsibility and what happens when there is disagreement by those with parental responsibility through a number of case studies. We provide information on specific legal and ethical issues surrounding neonates and decisions about treatment and raise awareness of issues surrounding parental responsibility, religious and cultural issues and the Human Rights Act. 

Moving onto older children, we focus on adolescent competence and when older children should be allowed to make decisions about their medical treatment including an exploration of ‘Gillick competence’ and when we should keep medical confidences related to older children.  There are opportunities throughout this Unit for you to relate your learning to real-world and hypothetical cases.

This last course unit explores the ethical and legal aspects of medical/healthcare confidentiality.

After exploring why medical confidentiality is important in a healthcare setting, we explain who is bound by a duty of confidentiality and what redress there may be for those whose confidence is breached unjustifiably. 

While medical confidentiality is important it is not absolute and thus we discuss when it might be justifiable or even legally required to breach medical confidentiality including in cases where there is shared genetic information. This Unit will help you to be aware of current legal guidelines on confidentiality including statute law on confidentiality.  You will also explore the specific legal situation regarding confidentiality and children and adolescents.