Re C Case Analysis: Ethics In The Common Law

This essay will evaluate the decision in Re: C. Considering the points of view the courts had to weigh up, and the difficulties presented to them, this study will analyse these elements against various ethical approaches to law, and their effects on any potential outcome, before reaching a reasoned conclusion on my own preferred ethical approach. In the case of Re: C, the courts were faced with an onerous decision. Should the potential to negate the death of an individual hold precedence over their own free will in regards to their treatment and, more importantly, their own life?

This task was made substantially more strenuous due to the patients diagnosed chronic paranoid schizophrenia. The court was obliged to not only decide whether the patient had a right to choose his own medical decisions, but also whether he was even mentally capable of doing so. Generally in cases relating to medical issues, the courts apply the rule based approach to find the most ethical outcome. In using this approach, the judiciary establishes an impersonal and deontological set of moral guidelines which must be adhered to, regardless of the facts of the individual case. An example of such guidelines would be ‘do not kill’, and in turn, the courts would rule that assisted suicide can never be lawful as its outcomes never satisfy the generalised moral standards, as seen in R (on the application of Nicklinson and another) v Ministry of Justice and R (Purdy) v Director of Public Prosecutions. If the judges were to use this approach in Re: C, then the patient's right to bodily integrity, and free choice over their own medical treatment, would be disregarded in favour of forced treatment to prevent death, which would have been seen as an unjust outcome. However, the appeal courts instead turned to the outcome based approach to ethics in their decision. The outcome based approach considers all factors, rather than adhering to strict rules and considers what is ‘good’ by examining the overall picture. A key influence of this approach is the concept of utilitarianism and the felicific calculus, or happiness factor. This perspective aims to do good for the greatest amount of people and in its application in the case of Re: C, the patient did not require surgical treatment. This is because it would make him happier to ‘die with two feet’ than ‘live with one’, and this outcome would not affect the happiness of any other individual.

A similar decision was made during the cases of Best v Chief Land Registrar and Re A. The greatest good was provided for the greatest amount of people, adhering to the pareto efficiency. In my opinion, the outcome based approach shows a greater level of moral conscience, in general, than the rule based approach. A key factor for this is the flexibility of its application based on individual facts. The concepts of law and morality have been entwined for centuries, and it is accepted in the common law system of England and Wales that it is impossible for the law to be regarded as a strict set of rules. Rather, the use of terminology within legislation and the concept of case law has allowed for laws to be applied, and guilt to be determined, based on the individual case facts. It therefore seems absurd to apply the similar concept of morality in such a rigid way so as not to allow an analysis of the individual case facts. Should I have been the judge in Re C, I would have found precedent in the concept of an individual's right to choose, or refuse, their own medical treatments over the prevention of their potential death. A key determining factor in this case would have been based on the outcome based approach, ensuring the pareto efficiency by the patient being happy with two feet, rather than unhappy with one. However, I would have placed greater insistence that the patients mental ability to make an informed decision be tested before putting a blanket ban on all present and future surgeries, due to their diagnosis of chronic paranoid schizophrenia.

In conclusion, I believe that the decision of the courts in Re: C was ethically justifiable due to the pareto efficiency and felicific calculus. Id equally agree that they were correct in choosing to follow the outcome based approach as the facts of the case were so unusual, and it would be impossible for it to correspond to the rigid tests of the rule based approach.