Sarka Specianova
First Faculty of Medicine Charles University, Czech RepublicPresentation Title:
Who represents the patient with limited autonomy?
Abstract
The presentation will deal with the situation of who is the representative of a person with limited autonomy, and who can decide on the care provided to the patient. Autonomy is a key ethical and legal principle in health care provision. We can define it as a manifestation of the patient legal and mental capacity to understand information related to the health care provision, and then make an informed decision in the form of informed consent. There is a presumption that an adult patient has the full capacity to decide on health care provision. But autonomy is not absolute and therefore it is limited. Not only minors have limited autonomy, but also adult persons for whom the court defined the extent to which it has limited a person's ability to act independently legally. If a patient cannot consent or refuse health care due to lack of capacity, then the decision is made by the patient´s legal representative.These situations will present with specific examples and will be demonstrated by references to the court decisions. These reflect not only the legal regulations but also ethical principles. The presentation will provide a practical context without dwelling on legal minutia. And will allow the audience to compare the practical examples and cases with their own experience from their countries of origin.
Biography
Sarka Specianova specializes in medical law and social-legal protection of children. She combines academic activities as a teaching assistant at the Institute of Public Health and Medical Law of the 1st Faculty of Medicine of Charles University in Prague with practical application of law as lawyer at a University hospital in the clinical research department. She is a member of the Ethics Committee of the General University Hospital in Prague. She lectures in courses and workshops for physicians, social workers, and public guardians who represent persons with limited autonomy, as well as for applicants for adoption and foster care.
She contributed to the reference book Neurodegenerative Diseases, where she authored several chapters devoted to the legal context of neurodegenerative diseases with a focus on the care of these patients (informed consent, communication of the diagnosis, previously expressed wishes, ability to drive motor vehicles and clinical trials in patients with limited autonomy).
She is a member of the Society for Social Paediatrics and the Czech Microbiome Society of the Czech Medical Association.
In the area of social and legal protection of children, she focuses on substitute family care and legal protection of abused and neglected children. She is the co-author of Recommendations for Practice – An Abused and Neglected Child in a General Practitioner's Surgery for Children and Adolescents and Recommendations for the Use of Imaging Methods when a Child is suspected of Being Abused. She worked on helplines for children.