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When ‘Sanctity of Life’ and ‘Self-Determination’ clash: Briggs versus Briggs [2016] EWCOP 53 – implications for policy and practice
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  • Published on:
    Briggs versus Briggs [2016] EWCOP 53: The clash of the ‘sanctity of life’ and the ‘third- party determination’ of the best interests
    • Mohamed Rady, Critical Care Medicine Consultant Mayo Clinic Hospital, Phoenix, Arizona, USA
    • Other Contributors:
      • Joseph L. Verheijde, Department of Physical Medicine & Rehabilitation

    To The Editor

    Kitzinger et al argued in favor of applying “the ‘holistic’ approach outlined in the Briggs judgment” to ascertain, in Court and ‘on the floor’, what in accordance with the Mental Capacity Act 2005 (MCA) ought to be considered a patient’s best-interest assessment.[1] In Briggs versus Briggs [2016] EWCOP 53 , “all parties were required to address the question of [Paul Briggs’s] ‘best interests rather than seeking to apply the standard of ‘substituted judgment’.”[2] Authors correctly pointed out that the MCA mandates, next to consideration of a person’s past and present wishes and feelings, values and beliefs, the inclusion of other relevant circumstances, i.e., diagnosis, prognosis and ‘sanctity of life’. Kitzinger et al postulated that this holistic approach to the best interest standard not only should be the preferred pathway over that of the ‘substituted judgment’ standard, but, if widely accepted, would make a positive contribution to “the texture and quality of best-interest decision making about these patients [with disorders of consciousness] ‘on the ground’”.[1] They further highlighted the significance of the Briggs judgment because of “the great weight [Mr Justice] Charles J gave the person’s own views, even when set against ‘sanctity of life’.”

    There are theoretical and practical problems with Kitzinger et al’s position.

    First, it is incorrect to describe the Briggs case as the clash of ‘sanctity of life’ and ‘self-determinat...

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    Conflict of Interest:
    None declared.