Oxford BA: Consent & Capacity Exam Paper

Martha, aged 16, is pregnant and wishes to terminate her pregnancy. She explicitly asks the doctor not to inform her parents. Dr. Smith believes Martha understands the nature and consequences of the procedure. However, Martha's mother arrives at the clinic, having discovered the appointment through Martha's diary, and demands to be informed about her daughter's medical condition and treatment plans. She argues that as Martha's parent, she has the right to make medical decisions on her behalf. Meanwhile, Martha's boyfriend Tom, also 16, claims he should be consulted as the father. Dr. Smith is also concerned because Martha mentioned she might change her mind 'depending on what happens at home tonight.' The clinic's policy requires a 48-hour cooling-off period, but Martha insists she needs the procedure immediately as she cannot face telling her parents if the delay means the pregnancy becomes more apparent. Advise Dr. Smith on the legal and ethical issues surrounding consent and confidentiality in this scenario.

Critically evaluate the extent to which the law strikes an appropriate balance between respecting patient autonomy and protecting vulnerable individuals in the context of capacity assessment under the Mental Capacity Act 2005.

Professor Williams, a 72-year-old academic, was diagnosed with early-stage Alzheimer's disease six months ago. While his long-term memory remains intact, he experiences increasing short-term memory problems and occasional confusion. Three years ago, when in perfect health, he executed a detailed advance directive refusing 'any life-prolonging treatment including artificial nutrition and hydration' if he developed dementia and could no longer recognise his family. The directive was witnessed and legally valid. He has now developed pneumonia and requires antibiotic treatment to survive. Although he cannot remember executing the advance directive and currently expresses a strong desire to live, saying 'I want every possible treatment,' he fails to recognise his wife of 45 years and believes he is still teaching at university. His wife supports following the advance directive, stating 'This is exactly what he feared most.' His adult children are divided: his son argues the directive should be followed as it represents his father's autonomous choice, while his daughter contends that his current expressed wishes should take precedence. The treating physician, Dr. Roberts, questions whether antibiotics constitute 'life-prolonging treatment' and wonders if the advance directive applies to this situation. Advise Dr. Roberts on the legal framework governing this decision.

To what extent does the current law adequately protect the interests of patients when informed consent is vitiated by therapeutic privilege, emergency circumstances, or public health imperatives?