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Ethics and the law: injections, best interests and duty of care
  1. Rob George, Consultant and Senior Lecturer and
  2. Bridgit Dimond, Professor
  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


An occasional, but major, challenge occurs when conflict arises regarding what constitutes appropriate medical treatment. Such conflict may arise when dealing with patients suffering from a chronic disease, whose knowledge of their illness outstrips that of the healthcare professionals involved in their care. When the conflict relates to a symptom such as pain, the distress experienced by all involved can derail the care process completely. Such a case is highlighted in this article (see Case scenario box). The case raises difficult questions regarding how to apply the principles that have previously been discussed in this ethical and legal series. The Case scenario raises two questions: (1) What is the patient’s best interest? (2) What is the clinicians’ duty of care? However, this level of questioning will prove to be insufficient to solve the dilemma experienced by the people in the Case scenario. The Case scenario prompts the reader to ask whether knowing what a person says is in his or her best interest automatically translates into the clinician being obliged to meet that demand. The article provides an ethical analysis, examining the legal and professional standards appropriate to the case.

  • Best interests
  • Causing harm
  • Duty of care
  • Mental Capacity Act 2005
  • Symptom management

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