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Ethics and the law: expressing choices for end-of-life care
  1. Rob George and
  2. Bridgit Dimond
  1. Ethical aspects: Rob George is Consultant in Palliative Medicine and Senior Lecturer in Biomedical Ethics, University College London. Legal aspects: Bridgit Dimond is Emeritus Professor, University of Glamorgan


The previous cases in our short series on mental capacity covered a patient in the last days of life who was incapable of making decisions and a patient who was quite capable of making her own decisions but elected not to do so. This, the third case, covers a very important aspect of care — knowing what patients wish for their future care should they become incapable of making their wishes known. The article will also examine the problems that arise when family members’ views with regard to future treatment options differ from those of the patient. The Mental Capacity Act 2005 sets in law important rights both for the patient and those close to them. Within this article we cover one of the central planks of the legislation: what patients are able to do to ensure that their wishes are clearly and unambiguously known. The article will examine the legal and ethical issues of the Case scenario presented (see box) and show how the situation was managed.

  • Best interests
  • Capacity
  • Consent
  • Islam
  • Mental Capacity Act 2005

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