The Catholic Bishops' Conference of England and Wales and the Linacre Centre for Healthcare Ethics have issued a strongly-worded Response today, to the government consultation paper: Making Decisions: Helping People who have Difficulty Deciding for Themselves. The Response was prepared by the Linacre Centre and submitted to the Lord Chancellor's Department by Archbishop Peter Smith as Chairman of the Conference's Department for Christian Citizenship and Responsibility. It calls for major changes to the leaflets drafted by the Lord Chancellor's Department, which are aimed at giving guidance on the care of adults who are mentally incapacitated. While accepting that the leaflets contain helpful advice on financial and other matters, the Linacre Centre says that "in the area of healthcare, we believe the leaflets need extensive revision". The Response says: "The role of the doctor in protecting patients' interests is neglected in the leaflets: it is often unclear that the 'best interests' of the incompetent person are his or her objective best interests, including clinical best interests. "On the contrary, 'best interests' often seem to be collapsed into what the patient wanted, or would have wanted, or (in practice) what other people think (or say) the patient wanted, or would have wanted. "There is also no recognition of the medical complexity of advance refusals of treatment, nor of the fact that advance refusals - like contemporaneous refusals - can have a suicidal motivation." The Response also says the leaflets are "uncritical of existing law permitting abortion and sterilization of mentally disabled women, and deliberate killing by omission of patients in a 'persistent vegetative state' or similar condition." It finishes by pointing out: "Despite many good features of the leaflets in the Making Decisions consultation, they fail to protect the very people whose interests they are designed to serve."
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