Event Date: 26 September 2015
Barts Pathology Museum
Robin Brook Centre
London EC1A 7BE
“DYING WELL”: ENACTING MEDICAL ETHICS
A cross-disciplinary Symposium at Barts Pathology Museum
Baroness Ilora Finlay (Professor of Palliative Medicine and member of the House of Lords) – The Role of Legislation in End-of-Life Care
In clinical medicine, an ethical framework is often based on the original work of Beauchamp and Childress. Recent legislation on human rights has altered the role of the clinician towards ensuring greater consideration of the patient’s needs and wishes, sometimes to the loss of the wider societal protections of the law.
End-of-life care is inadequate across the world. It is often patchy, both in availability across 24/7 and in the geographical distribution of services, quite apart from being less accessible to patients with non-cancer diagnoses. Such service development flies in the face of the principle of justice and often leaves clinicians unable to respect autonomy or to avoid harm (non-maleficience).
Legislation has been introduced in Belgium but it has had little effect on the development of specialist palliative and end-of-life care services.
My Private Members Bill, the Access to Palliative Care Bill, has been written to ensure improvement in service provision: it will ensure each patient with need of specialist input can access a service, that services are adequately funded and commissioned, and that the general health and social care workforce is adequately trained. Such training must involve the principles of pain control, the importance of facilitating key conversations and the Mental Capacity Act, which allows for advance decisions to refuse treatment even if that decision is deemed ‘unwise’.
It places the framework of modern healthcare ethics into the context of mandatory provision of adequate services.