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Hassell v Hillingdon Hospital NHS Trust. 2018;

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Konovalova v Russia. 2014;

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Coercion or consent?

02 July 2018
Volume 26 · Issue 7


All patients have the right to consent to, or refuse, treatment, but this can present ethical dilemmas when pitted against medical expertise. Paul Golden examine the legal implications for midwives

The principle of ‘do no harm’ has been a part of medicine since the Hippocratic oath more than 2000 years ago. Expanded upon by the United Nations' Universal Declaration of Human Rights (1948), this has long been part of English law.

‘Bodily autonomy’ has been respected in law as a fundamental right including the right to decide who touches or treats a person. In the case of Airedale NHS Trust v Bland [1993], Lord Keith stated that:

‘Even when his or her own life depends on receiving medical treatment an adult of sound mind is entitled to refuse it. This reflects the autonomy of each individual and the right of self-determination.’

The UK Supreme Court case of Montgomery v Lanarkshire Health Board [2015] demonstrated how the courts were willing to uphold women's choices, ensuring informed consent and refusal are respected. Women are experiencing and reporting coercion in childbirth (see ‘Women's Voices' Facebook campaign, which has spread to many countries including the US and Italy). This has been named ‘obstetric violence’, a term that focuses on systemic issues of coercive practices coming from health professionals (Skoko and Battisti, 2018).

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