Mary Donnelly

Bio: Mary Donnelly is an academic researcher from University College Cork. The author has contributed to research in topics: Autonomy & Context (language use). The author has an hindex of 13, co-authored 54 publications receiving 519 citations.

Best interests, patient participation and the mental capacity act 2005

Abstract: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Medical Law Review following peer review. This article analyses the best interests standard as applied in the context of healthcare decisions in light of the participative elements introduced by the Mental Capacity Act (EW). It begins with a brief consideration of the best interests standard as it developed at common law. The article shows that, while the courts gradually developed a more systematic approach to best interests, judges remained largely resistant to facilitating participation by patients lacking capacity. The article examines the changes brought about by the MCA in this regard. It explores the policy basis for this aspect of the MCA and shows why the participative model represents the most appropriate response to decision-making for people lacking mental capacity. The article argues that notwithstanding the attractions of the MCA’s participative framework from a policy perspective, this approach to best interests gives rise to important practical and conceptual questions, which the article then explores. The article examines the difficulties in delivering genuine participation at a practical level and identifies the risk that patient participation will become a tokenistic endeavour.

Healthcare Decision-Making and the Law: Autonomy, Capacity and the Limits of Liberalism

Abstract: Introduction 1. Autonomy: variations on a principle 2. Autonomy in the law 3. Capacity: the gatekeeper for autonomy 4. Capacity assessment in practice 5. Autonomy, rights and decision-making for people lacking capacity 6. Treatment for a mental disorder: a case apart Conclusion.

Participation in Healthcare: the Views and Experiences of Children and Young People

Abstract: Article 12 of the Convention on the Rights of the Child provides for the child's right to be heard and to be involved in decisions made about him/her. Effective implementation of the provision can have a lasting impact on children's lives but it presents challenges, especially in areas like healthcare where the dynamics and pressures of the healthcare setting and the role of parents influence proceedings. Research involving children shows that their experience in this area is mixed, although they have a clear sense of the importance of being listened to about their healthcare and how their treatment can be improved. The similarities between children's opinions on what they want from the healthcare experience and what Article 12 and the Convention generally set out to achieve is reassuring and presents a strong template as to how to strengthen the protection of children's rights in the healthcare setting.

Child-friendly healthcare: delivering on the right to be heard.

Abstract: Under the United Nations Convention on the Rights of the Child (CRC), children capable of forming views have the right to express those views and have them taken into account in all decisions that affect them. Attention has only focused recently on the child’s right to be heard in the context of healthcare decision-making. This article addresses this issue from both a legal and a medical perspective. It begins by considering what participation means and by differentiating between autonomous decision-making by children and children’s participation in decision-making. It then evaluates the current state of participation in practice, drawing especially on a study conducted by the authors into the realities of children’s participation in healthcare decision-making in Ireland. This study helps identify a number of barriers to the delivery of participative practices. In particular, it identifies the potentially inhibiting role of parents, a finding which is replicated by studies in other jurisdictions. The article then investigates the legal status of parental objections to children’s participation and argues that both the CRC and the European Convention on Human Rights provide legal support for a requirement that the child’s right to participate in healthcare decision-making must be protected, even in the face of parental objections. The article also argues that focused legislation and codes of practice have a valuable contribution to make to the delivery of children’s participation rights in practice and that the introduction of such measures should be a priority.

Best Interests in the Mental Capacity Act: Time to say Goodbye?

Abstract: Article 12 of the United Nations Convention on the Rights of Persons with Disabilities, as interpreted by the Committee on the Rights of Persons with Disabilities in General Comment No. 1, offers a vision for law's response to capacity impairments which differs in crucial ways from that contained in the Mental Capacity Act 2005. The Committee rejects the functional test for capacity and requires that a 'will and preferences' paradigm must replace the 'best interests' paradigm and that all substitute decision-making regimes must be abolished. This article draws on the position adopted in General Comment No. 1 in evaluating the best interests standard in the Mental Capacity Act. It sets out the normative case for a stronger legislative endorsement of will and preferences and the inclusion of greater support mechanisms but rejects the contention that all substitute decision-making can, or should, be abolished. It also argues that the best interests standard in the Mental Capacity Act retains some revolutionary potential and that, pending legislative reform, this can be further developed through the courts.

In a Different Voice. Psychological Theory and Women’s Development. Cambridge, MA (Harvard University Press) 1982.

Abstract: Introduction 1. Woman's Place in Man's Life Cycle 2. Images of Relationship 3. Concepts of Self and Morality 4. Crisis and Transition 5. Women's Rights and Women's Judgment 6. Visions of Maturity References Index of Study Participants General Index

The culture of control: crime and social order in contemporary, society

Abstract: Nos últimos trinta trinta anos, houve profundas mudanças na forma como compreendemos o crime e a justiça criminal. O crime tornou-se um evento simbólico, um verdadeiro teste para a ordem social e para as políticas governamentais, um desafio para a sociedade civil, para a democracia e para os direitos humanos. Segundo David Garland, professor da Faculdade de Direito da New York University, um dos principais autores no campo da Sociologia da Punição e com artigo publicado na Revista de Sociologia e Política , número 13, na modernidade tardia houve uma verdadeira obsessão securitária, direcionando as políticas criminais para um maior rigor em relação às penas e maior intolerância com o criminoso. Há trinta anos, nos EUA e na Inglaterra essa tendência era insuspeita. O livro mostra que os dois países compartilham intrigantes similaridades em suas práticas criminais, a despeito da divisão racial, das desigualdades econômicas e da letalidade violenta que marcam fortemente o cenário americano. Segundo David Garland, encontram-se nos dois países os “mesmos tipos de riscos e inseguranças, a mesma percepção a respeito dos problemas de um controle social não-efetivo, as mesmas críticas da justiça criminal tradicional, e as mesmas ansiedades recorrentes sobre mudança e ordem sociais”1 (GARLAND, 2001, p. 2). O argumento principal da obra é o seguinte: a modernidade tardia, esse distintivo padrão de relações sociais, econômicas e culturais, trouxe consigo um conjunto de riscos, inseguranças e problemas de controle social que deram uma configuração específica às nossas respostas ao crime, ao garantir os altos custos das políticas criminais, o grau máximo de duração das penas e a excessivas taxas de encarceramento.

Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine

Abstract: The last decade has witnessed the continued growth and evolution of medical ethics into a mainstream medical discipline, and paralleling this maturation is an increasing array of textbooks. Clinical Ethics , now in its third edition, has successfully spanned that decade to become one of the most popular, concise texts in the field. The well-known authors, an ethicist, clinician, and legal scholar, have considerable overlapping expertise, which, fortunately, results in a consistent literary style more typical of a single-authored work. The espoused purpose of the book is twofold: to serve as a reference work of reflective opinion about typical ethical problems that occur in medical practice and to develop a method for analyzing such problems as they occur. The structure of the text is unique with five main topics and chapters covering indications for medical intervention, preferences of patients, quality of life, contextual factors (such as social, economic, and legal issues),

Book review: Experimental techniques in plant disease epidemiology, J. Kranz & J. Rotem (eds.). Springer-Verlag Berlin, 1989, 299 pp.

Abstract: Various textbooks have been written on the epidemiology of plant diseases. Most of them present theory of epidemiology, thus giving a description of epidemiological principles. Some of these are of a general nature, whereas others concentrate on specialized subjects, but there are no books on experimental techniques in epidemiology. This omission has been recognized and rectified by Kranz and Rotem. As mentioned in their preface they intended, by editing and publishing the book, 'to help in the development of a methodology able to provide a choice of adequate methods widely acceptable amongst epidemiologists for varying applications and objectives'. For this purpose, they invited 27 distinguished plant pathologists, a number of them from Kranz's 'stable', to participate, and to provide information from their own rich experience. There are 20 chapters spread over four sections. Section I (General techniques), deals with techniques and approaches used in experiments in the field and under controlled conditions. Advantages and disadvantages of such experiments and the relations between them are explained. In Section II (.Measurements and their analysis) disease assessment, crop development and estimation of spore production, dispersal, survival and infectiousness are treated. The analysis of spatial patterns of soil-borne pathogens {s discussed in a separate chapter, for soil-borne diseases have to be approached differently. This section is concluded with two chapters on the monitoring and analysis of environmental factors. Section III (Special topics) is a collection of items, such as the analysis of the effects of control measures, fungicide resistance, virulence in pathogen populations, components in yield loss, development of forecasters, aphid-borne epidemiology, quantitative nematology, geophytopathology and long-distance dispersal. As the editors explain, these are 'not necessarily connected with each other, but all dealing with definite objectives in epidemiological experimentation'. The reasoning for the addition of these topics to the contents is clear. Most are worth treatment, and each has specialized techniques and approaches. The reasoning for collecting them all together under 'Special topics' is a little unsatisfactory. A rather simple rearrangement and naming of the subjects could separate them into a couple of better defined chapters, which would have made the contents more accessible to the eager user. Section IV (The synopsis of experimental restilts) gives the reader a look into the methods in comparative epidemiology, and into the development and use of simulation models for root and foliar diseases. The limitations, necessarily imposed upon the authors, to prevent the publication of an unwieldy and ever more expensive handbook lead to the question whether the editors 'bit more than they could chew'. Especially the chapters on modeling and simulation suffer under these limitations. Most authors have achieved a fine work, though readers, familiar with the authors' publications, can 'taste' a bit of subject.ivity in the choice and approach of techniques and methods by some of them. The book might be a useful addition to the library of all those involved in experimental work in epidemiology, but particularly those called 'novices in epidemiology' in the preface. The editors may have had undergraduates and young postgraduates in mind, but this work might be useful for other epidemiologists too. It is a pity that the high price will hinder young scientists from purchasing the book, particularly those in developing countries.