AMBIENTUM BIOETHICA BIOLOGIA CHEMIA DIGITALIA DRAMATICA EDUCATIO ARTIS GYMNAST. ENGINEERING EPHEMERIDES EUROPAEA GEOGRAPHIA GEOLOGIA HISTORIA HISTORIA ARTIUM INFORMATICA IURISPRUDENTIA MATHEMATICA MUSICA NEGOTIA OECONOMICA PHILOLOGIA PHILOSOPHIA PHYSICA POLITICA PSYCHOLOGIA-PAEDAGOGIA SOCIOLOGIA THEOLOGIA CATHOLICA THEOLOGIA CATHOLICA LATIN THEOLOGIA GR.-CATH. VARAD THEOLOGIA ORTHODOXA THEOLOGIA REF. TRANSYLVAN
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Authors: EMANUELE VALENTI.
DOI: 10.24193/subbbioethica.2021.spiss.120
Published Online: 2021-06-30
Published Print: 2021-06-30
pp. 176
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ABSTRACT: Parallel Session IV, Room 1 ‘Best interests’ decisions are often needed when patients lack capacity to make their own healthcare decisions. Despite the ubiquity of ‘best interests’, there remains considerable ambiguity about what best interests are and how the standard should be applied, alongside a lack of understanding about how best interests decisions are actually made in clinical practice. Balancing Best Interests in Healthcare Ethics and Law (BABEL) is an interdisciplinary project, funded by a Wellcome Trust Collaborative Award, which aims to explore best interests decision-making in healthcare, both empirically and normatively. In this paper, we outline initial findings from a narrative review that asked, ‘what evidence do we have about how best interests decisions are made in clinical practice in England and Wales?’. Data were extracted from included papers using a standardised form, and then subjected to thematic analysis, focussing on what the papers told us about the process of decision-making, the stakeholders involved, the barriers and facilitators. Early results suggest we have some limited evidence about how best interests decisions are made in clinical settings, and the majority of this evidence concerns mental health and end-of-life care. Common factors taken into account in these decisions include: the patient’s clinical circumstances; risk assessment; the patient’s wishes; cost-effectiveness; avoiding harm; the patient’s well-being; autonomy; capacity assessment; and family’s wishes.
