Mencap backs doctor’s guidance on treatment but wants safeguards

Learning difficulties charity Mencap has
welcomed the General Medical Council’s proposed guidelines for
doctors about withholding or withdrawing a patient’s
life-prolonging treatment.

The
draft guidelines, which the GMC hope will be approved this week,
“rightly explore some of the difficult considerations when making
often distressing decisions on withholding medical treatment,”
Mencap says.

But
head of campaigns, Richard Kramer has warned that the guidelines
need to be accompanied by new legislation, if the rights of
disabled people are to be safeguarded.

“Under
the current legal framework it is unclear who has the right to make
day-to-day decisions about health care or welfare on behalf of
people who lack the capacity to make decisions independently,”
Kramer said.

“Mencap is campaigning for new
legislation on mental capacity to ensure that families can
challenge the decisions of doctors and that severely disabled
adults receive appropriate care, medical treatment and protection,”
he added.

The
GMC’s draft guidelines claim that where adult patients lack
capacity to decide for themselves, the doctor must take account of
their wishes when making an assessment of the benefits, burdens,
risks and acceptability of proposed treatment .

But
where a patient’s wishes are not known, it is the doctor’s
responsibility to decide what is in the patient’s best interests.
The guidance says this cannot be done without information about the
patient, and people close to the patient are “best placed to
know”.

The
guidelines also suggest that when a health team, doctor and those
close to the patient reach different conclusions about the course
of treatment “it is important to take time to try to reach a
consensus about treatment and it may be appropriate to seek a
second opinion, or other independent or informal
review”.

Where
there are doubts about a patient’s capacity to make a decision, the
guidelines suggest a thorough assessment consulting relevant
professional guidelines, where appropriate a second opinion and if
there is still doubt, legal advice must be sought, which may
include asking a court to determine capacity.