Autonomy is often said to be the dominant ethical principle in modern bioethics, and it is also important in law. Respect for autonomy is said to underpin the law of consent, which is theoretically designed to protect the right of patients to make decisions based on their own values and for their own reasons. The notion that consent underpins beneficent and lawful medical intervention is deeply rooted in the jurisprudence of countries throughout the world. However, Autonomy, Consent and the Law challenges the relationship between consent rules and autonomy, arguing that the very nature of the legal process inhibits its ability to respect autonomy, specifically in cases where patients argue that their ability to act autonomously has been reduced or denied as a result of the withholding of information which they would have wanted to receive.
Sheila McLean further argues that the bioethical debate about the true nature of autonomy – while rich and challenging – has had little if any impact on the law. Using the alleged distinction between the individualistic and the relational models of autonomy as a template, the author proposes that, while it might be assumed that the version ostensibly preferred by law – roughly equivalent to the individualistic model – would be transparently and consistently applied, in fact courts have vacillated between the two to achieve policy-based objectives. This is highlighted by examination of four specific areas of the law which most readily lend themselves to consideration of the application of the autonomy principle: namely refusal of life-sustaining treatment and assisted dying, maternal/foetal issues, genetics and transplantation.
This book will be of great interest to scholars of medical law and bioethics.
'Through a detailed and wide-ranging theoretical, legal, and social analysis, McLean provides a thoughtful and powerful response to those who would argue that English and Scottish medical and healthcare laws have the promotion of patient autonomy at their heart.'
John Coggon, Research Fellow on the Wellcome project, The Human Body- Its Scope, Limits and Future, Institute for Science, Ethics, and Innovation, School of Law, University of Manchester
1. Autonomy Introduced 2. Autonomy in Law 3. Consent and the Law 4. Autonomy and Pregnancy 5. Autonomy at the End of Life 6. Autonomy and Transplantation 7. Autonomy and Genetics 8. Autonomy and Consent Revisited
Scientific and clinical advances, social and political developments and the impact of healthcare on our lives raise profound ethical and legal questions. Medical law and ethics have become central to our understanding of these problems, and are important tools for the analysis and resolution of problems – real or imagined.
In this series, scholars at the forefront of biomedical law and ethics will contribute to the debates in this area, with accessible, thought-provoking, and sometimes controversial ideas. Each book in the series will develop an independent hypothesis and argue cogently for a particular position. One of the major contributions of this series is the extent to which both law and ethics are utilised in the content of the books, and the shape of the series itself.