Legal process, litigation, and judicial decisions

Ethically salient issues in neurologic care may have important legal overtones. This chapter considers some of these, emphasizing how law may influence the outcome of controversies over how best to promote autonomy, beneficence, and justice in the care of individuals with neurologic disorders. Constitutional, statutory, and judicial dimensions are addressed. With respect to autonomy, discussion emphasizes legal dimensions of the doctrine of informed consent and the obligations of medical professionals to protect the privacy and confidentiality of their patients. The discussion of beneficence focuses on issues relating to actual or potential conflicts of interest in the care of patients and on the conduct of research involving human subjects. The section on justice considers how law aims to define protectable rights and interests of individuals and to provide a fair and efficient process for resolving disputes. Applications of legal principles and doctrines are illustrated primarily through the examples afforded by judicial decisions. These cases demonstrate how law both promotes ethical decision-making and protects the rights and interests of those affected. The cases also highlight some of the ethical quandaries that evoke resort to litigation and the limits of law in advancing ethically appropriate outcomes.