Mental Capacity Act comes into effect
2 April 2007
The Mental Capacity Act 2005 comes partially into effect at the beginning of April 2007, and the Daily Mail reports on serious concern from several doctors opposed to elements in the Act which would give legally binding force to living wills and healthcare powers of attorney. Dr Peter Saunders of the Christian Medical Fellowship said that the act was dangerous to mentally incapacitated people who are not dying. Dr Philp Howard expressed his unwillingness to allow a patient to die of unrelieved thirst, and Dr Adrian Treloar said that if asked to kill patients on the authority of the Act he would refuse. [Daily Mail, 30 March]
The Glasgow-based Herald reports that The British Medical Association (BMA) has published guidelines for end-of-life treatment. The aim of the guidelines is to make doctors and patients more aware of their legal rights and obligations. No mention is made in the report of the Mental Capacity Act, which does not apply in Scotland. Dr Lewis Morrison, the Scottish representative on the BMA ethics committee, is quoted saying: "The worst situation is one where doctors are too afraid to stop treating because of the fear of being prosecuted." [Herald, 31 March]The BMA also advises people to consider granting power of attorney over health decisions to a friend or relative, under the terms of the Mental Capacity Act. Attorneys will be able to "choose between treatments" offered by a doctor and: "Any decision must be in the patient's best interests and doctors or family can take the case to a new court of protection" [Guardian, 31 March] Comment: Section 50(1) of the Act makes clear that that neither relatives nor doctors will have an automatic right to go to the Court of Protection.
Independent mental capacity advocates (Imcas) are beginning work today as the first stage of the Mental Capacity Act is implemented. English and Welsh Local authorities and NHS trusts will be required to appoint an Imca whose purpose will be to help people without friends and family make decisions about serious medical treatment and changes in residence. The advocates will be commissioned by councils and primary care trusts. [Community Care, 2 April] Formal authority for appointment of Imcas rests with the Secretary of State (in England) and the National Assembly (in Wales).
The first baby in Britain designed so as to be free from the risk of developing early Alzheimer's is being planned by doctors. Mr and Mrs de Beer, from London, who have a strong family history of early-onset Alzheimer's, will undergo IVF and then have their embryos screened for the genes that predispose people to the disease. The embryos that have the genes will be destroyed. The couple's doctor, Professor Gedis Grudzinskas, medical director at the Bridge Centre fertility clinic in London, is applying for a licence for the procedure to the Human Fertilisation and Embryology Authority. He said: "Society is becoming more comfortable using this powerful technology to avoid conditions that cause distress by creating what silly people call 'designer babies'." Dr David King, director of Human Genetics Alert, said: "We can confidently expect science to find a cure for Alzheimer's in the next 40 years. I don't believe that it is better never to have been born than to live a healthy life for 45 years and die from Alzheimer's." [Sunday Times, 1 April]
The Human Fertilisation and Embryology Authority (HFEA) in Britain may consider reducing the number of embryos implanted in women undergoing IVF in an attempt to cut the high level of multiple births. They are also expected to outline possible restrictions on what kinds of IVF treatment should be available to infertile couples. Dr Simon Fishel, director of the Care fertility group in Nottingham, said: "The multiple birth issue is a problem. Any responsible practitioner would want to reduce any multiple pregnancy down to a single pregnancy because there are risks." He said that the HFEA should consider encouraging the implantation of single embryos wherever appropriate. [Guardian, 2 April] The HFEA has denied making any decision on restricting IVF treatment and has said that a public consultation will be launched to decide what action should be taken. [BBC, 1 April]
Adult stem cells taken from bone marrow have been used to grow part of a human heart, according to British scientists. Heart surgeon Sir Magdi Yacoub led a team of researchers at Harefield hospital in Middlesex, who cultivated stem cells into tissue that works in the same way as human heart valves. Sir Magdi said that he hopes in the future to be able to grow an entire heart from stem cells. He said: "It is an ambitious project but not impossible. If you want me to guess I'd say 10 years." [BBC, 2 April]