MRS X

The consensus of the group was that Mrs X made a self-determined choice and the doctor should respect her choice.

Some people also pointed out that the principle of Autonomy is a key factor in the scenario as well as Mrs X being 'Gillick Competence' and it was also stated that the fact she has a daughter makes it a difficult situation to evaluate; but, in the end it is still the patient’s decision.

http://www.ethox.org.uk/Ethics/econsent.htm

The above link was offered to bring light to the debate of consent.  Some discussion was made relating to the phrase ‘Law wins over Ethics’ in this scenario, but we will leave you with this to think about – what does a doctor do when his or her conscience suggests that an ‘illegal’ course of action is the morally correct route?  We have no answers at the moment

One member of the group pointed out an ethical question of allowing people to make there own decision about receiving treatment.  That is surely in some cases the result in euthanasia / self termination?  This was not debated further as we didn’t have much time left for discussion.

MRS Y

In evaluation whether this patient should receive treatment, the group felt that the best interest approach would have to be applied in these circumstances.

It was stated that just because she has a learning disability does not make her incompetent.  Although this was the consensus of the group, one member of the group did think that the clinician should treat Mrs Y because of her disability. Some also pointed out that we would need to know more about the disability.

In this scenario the case of Re C [1994] 1WLR 290 was debated and the link below was as used to support the case and the discussion.  In summary, Re C requires that the patient’s previously expressed views, if any, will always be an important component in the decisions of the doctors and the court, particularly if they are clearly established and were intended to apply to the circumstances which have in fact arisen.

http://www.ethox.org.uk/ethics/econsent.htm#capacity

Another question for you to think about, which was raised by one member of the group - Learning Disability: does it mean she is incompetent?  Further details would be needed to assess competence is this area, but we could assume that the might be difficulties in proving this for either eventuality.