of inhuman or degrading treatment construable as a legal entitlement to unproductive medical care where this is not clinically indicated, such as clinically assisted nutrition and hydration under circumstances deemed to be futile (Brazier & Cave, 2007).
BOX 17 Key Articles for healthcare in the 1950 European Convention on Human Rights (European Court of Human Rights, amended 2010)
Article 2 Article 3
Article 5 Article 6 Article 8 Article 9 Right to life (can relate to the limits of medical treatment)
Right to be free from subjection to torture or to inhuman or degrading treatment or punishment
Right to liberty and security of person (can relate to compulsory treatment)
Right to a fair trial (has a bearing upon situations where there is no redress in common law for breach of a Convention right)
Right to respect for private and family life, home and correspondence (relevant to disclosure, and to autonomy)
Right to freedom of thought, conscience and religion
Article 10 Right to freedom of expression (comes into play in situations that clash with Article 8)
Article 12 Right to marry and found a family, according to the national laws governing the exercise of this right (can relate to access to fertility services)
Article 14 Rights and freedoms of the Convention are to be enjoyed without discrimination on any ground such as sex, race, colour, language, religion, political or other opinion, national or social origin, association with a national minority, property, birth or other status
On the distinction between liberty rights and welfare rights, Brazier & Cave (2007) comment that “there is no positive right to health care”, and explain that “many European countries adopt a conservative approach to health care rights”, for example in France and Italy regarding access to and the options available in the provision of fertility services. A further learning resource in this area is the UNESCO Universal Declaration on Bioethics and Human Rights (2005).
Community of practice
This is a modern name for an age-old phenomenon discussed by Lave & Wenger (1991) in their modification of the traditional apprenticeship model. Apprentices, in their gradual formation as professionals, undertake ‘situated learning’, as relative outsiders, by means of their ‘legitimate peripheral participation’ within the domain of expertise for which they are being trained, which is constituted by the community of practitioners. The concept was further articulated systematically in terms of educational theory by Wenger (1998) in relation to social learning and transformative learning (for a critical perspective, see Illeris 2002). Maudsley & Strivens (2004) recommend a situated learning design that also incorporates reflection on experience as a “particularly powerful” approach for students’ professional education in medicine. The community of medical professionals is correspondingly fundamental to this type of learning, with clinical teachers having essential roles in the two loci of campus-based professional studies and learning in clinical contexts.
Guide 53: Ethics and Law in the Medical Curriculum 27
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