Deciding for oneself
Law and medical ethics increasingly make use of the concept of ‘decision-making capacity’ - the ability to make a decision for oneself about, for example, treatment. All of us at times can lose this capacity (e.g. when drunk or even in the height of passion) and all of us have spent our childhoods developing it. But how do conditions such as bipolar affective disorder, schizophrenia, depression, brain injury, and dementia affect our processes of decision-making? In the field of mental health, how can we develop fairer and more accurate ways to assess the loss of decision-making capacity, but also to support individuals in accessing and developing such capacities at times when these are under threat.
The kind of questions we address include:
- What characterises the lived experience (“phenomenology”) of decision-making in severe depression?
- How common is the loss of one’s ability to decide for oneself about treatment or research participation in both psychiatric and medical settings?
- What factors are typically associated with losing and regaining the capacity to decide for oneself?
We are interested in using this understanding to improve the way supportive decision-making and substitute decision-making is approached in health and social care and to explore whether policy/statute is a good fit or could be better adapted.
In: Phenomenology & the Cognitive Sciences, Vol. 14, No. 1, 03.2015, pp. 163-182.
In: BMJ (International Edition), Vol. 337, No. 7660, 2008
In: Psychological Medicine, Vol. 39, No. 8, 08.2009, p. 1389 - 1398.
Human rights and health
Human rights aim to be universal, ‘inalienable’ and apply to all people. Increasingly, human rights law is extending to healthcare where rights such as the right to life, health and liberty need to be interpreted in contexts of mental illness. Human rights is also moving towards a more ‘active’ model, by creating a framework supporting those with disabilities to become decision-makers, guiding their own lives and treatment. Our research aims to inform and develop human rights thinking by bringing mental health expertise into academic and policy debates.
In: British medical journal, Vol. 348, g3390, 21.05.2014
In: The Psychiatrist, Vol. 37, No. 9, N/A, 09.2013, p. 297-301
In: International Journal of Law and Psychiatry, 2015.
Our research has received funding from the Wellcome Trust, the NIHR, the Department of Health and the AHRC.
Inquiries regarding PhD/MD(Res) studies are welcomed.
Centre of Medical Ethics and Law
University of Essex: