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Simms v Simms [2002] and Best Interest in Special Cases

A 18-year-old male and a 16-year-old female suffering from variant Creutzfeldt-Jakob disease (vCJD) which rendered them mentally incapacitated. The parents of the patients wished them to receive a treatment that inhibits the formation of abnormal prion. They sought declaration that each patient lacked the capacity to consent to treatment. This is sought because vCJD is an incurable disease with no 'alternative' treatment.

Judgment held: granting the declaration as it is a 'benefit' to patients from such pioneering treatment where there is no 'alternative' treatment available.

Best interest in special cases

Best interest is a term of art especially when it comes to children, patients lack of capacity, and patients lack of available 'alternative' (incurable disease). Parental or guardian consideration is important in decision of children and those who lack of capacity. It must be a discretional decision and this raises the issue of fairness to the decision-maker when they make a health care decision for others because they feel that they need to bear certain responsibility with such a decision. An explicit consent must be sought in incurable diseases with no 'alternative' available. At the end, the best option of the 'best interest' is, of course, self-determination by the patients themselves.

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