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Medico-legal implications of drug treatment in dementia

Published online by Cambridge University Press:  02 January 2018

Shokoufa Manouchehri Kashani  and
Julian C. Hughes
Shokoufa Manouchehri Kashani
Affiliation:
Gibside Unit, Newcastle General Hospital, Westgate Road, Newcastle-upon-Tyne NE4 6BE
Julian C. Hughes
Affiliation:
Gibside Unit, Newcastle General Hospital, Westgate Road, Newcastle-upon-Tyne NE4 6BE
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Psychiatric Bulletin , Volume 26 , Issue 11 , November 2002 , pp. 436
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Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © Royal College of Psychiatrists, 2002

Sir: We read with interest the paper by Lawrence et al (Psychiatric Bulletin, June 2002, 26, 230-232), which was both informative and timely.

However, in discussing the difficulties encountered in obtaining consent in dementia, they state that the alternatives to valid consent ‘such as assent or vicarious approval by a carer, are unlikely to satisfy legal or moral requirements’. We disagree because these are not the only alternatives.

If an adult patient cannot give valid consent, because he or she lacks capacity, doctors must act in the person's ‘best interests’. Of course, this does not simply mean best medical interests. As the Lord Chancellor has reminded us, ‘best interests’ are determined by broad and careful discussion and negotiation (Reference HughesHughes, 2000). Decisions arising from such a process of open collaboration and mutual engagement will have both a legal footing and ethical basis.

References

Hughes, J. C. (2000) Ethics and the anti-dementia drugs. International Journal of GeriatricPsychiatry, 15, 538–543.Google Scholar
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