King’s College London Student Clinical Ethics Committee case discussion: A patient changes her mind about surgery – should her later refusal be respected?

Abstract

Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration – a female patient in her mid-60s, who had a very long history of multiple sclerosis, withdrew her previous consent to treatment following discussion with her son. The case study summarises the reflections of the Committee and focusses on: the meaning and practical application of respect for patient autonomy; whether a refusal of clinically indicated treatment may challenge the notion of capacity; the role of others in the process of decision-making; if the current decision to refuse treatment was the patient’s own and whether, in the circumstances, it should be respected.