Education And Debate

Ethical Debate: Presumption of incompetence

BMJ 1995; 311 doi: (Published 08 July 1995) Cite this as: BMJ 1995;311:117
  1. Zbigniew Szawarski, lecturera
  1. aCentre for Philosophy and Health Care, University College of Swansea, SwanseaSA2 8PP

    There are four options possible when a patient refuses treatment in an accident and emergency department. Firstly, the doctor responsible ignores the patient's decision and treats the patient against his or her will even if the patient has to be restrained. Secondly, the doctor respects the patient's decision and withholds treatment even if it means the patient's death. Thirdly, the doctor tries to negotiate with the patient. Fourthly, the doctor refers the case to a third party (a court of law or an ethics committee) to decide the issue. This last option is usually …

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