Summer School 2021 (online): Risk Decisions in the Contexts of Care and Law
The 2021 Autonomy Project Summer School was held online on the 20th-23th July.
About the Autonomy Project
The Essex Autonomy Project is a research and public policy initiative, based at the University of Essex, and investigating the ideal of self-determination (autonomy) in the context of care (health care, social care, eldercare, psychiatric care, etc.). Led by Professor of Philosophy, Wayne Martin, it involves extensive intramural and extramural collaboration with jurists, clinicians, service users, activists, civil servants, and policy makers. It is affiliated with the Wellcome-funded Mental Health and Justice project and the award-winning Essex Human Rights Centre.
About the Summer School
The Autonomy Project Summer School is an annual event, held each July, which brings together a group of researchers, activists, students, clinicians, social workers, service-users, and public officials in order to work together on the challenges of embedding respect for autonomy and human rights in the practices of care.
This year, the Summer School took place across 4 days from the 20th to the 23th July, with sessions running for 2 hours each day. There were additional, informal ‘meet at the bar’ sessions later in the day, lead by Wayne Martin. The structure aimed to keep attendees active and engaged, shifting between panel discussions and conversations in breakout rooms.
This Year’s Theme: Risk
This year issues of risk have loomed larger than ever across every sector of civil society. The pandemic has meant that we’ve all had to be especially vigilant about – and more ingenious than ever in negotiating – the risks that pervade our private and professional lives. In our 11th Annual EAP Summer School we highlighted and explored the role risk plays across a number of legal and care contexts. Among other things, we explored the following topics: risk work and the relative advantages of formal and post-formal approaches to risk assessment in care settings; the role of risk in mental capacity assessment and how that role is moderated by the severity of the risks involved; the place of risk in Mental Health Policy and psychiatric decision making; the precautionary principle and what it means for people who do frontline risk work; the wider background conditions that shape which risks feature in our decision making and which get ignored. As always, our presenters came from a variety of backgrounds – e.g., law, philosophy, sociology, psychiatry, and more – and we fostered interdisciplinary problem-focused conversations with a diverse group of academics, lawyers, psychiatrists, frontline care workers, and other professionals with a stake in these issues.
Dr Patrick Brown
(Department of Sociology, University of Amsterdam)
Patrick is an associate professor in the Department of Sociology and manages the research group on Political Sociology, within the Amsterdam Institute of Social Science Research. He is currently the Chair of the research network on Sociology of Risk and Uncertainty (RN22) within the European Sociological Association and the editor of Health, Risk & Society.
He has also worked on or coordinated a number of projects funded by, or carried out in cooperation with, organisations such as the Royal College of Physicians, the European Commission, the UK Government (Department of Work and Pensions) and the European Medicines Agency, looking at various aspects of client-experiences, trust and engagement of patients and professionals, and the implications of these for policy-making.
He recently finished a book On Vulnerability (Routledge 2021) and is currently working with colleagues at Århus, Leiden and Vienna on
the REACTOR project, financed by DFF (Independent Research Fund Denmark).
Dr Nicola Gale
(University of Birmingham)
Nicola’s core substantive research interest is health care practice and the everyday work of professionals, para-professionals, complementary and lay healthcare workers, particularly those working in community and primary care settings.
Her research cuts across the sociology of health and illness, embodied sociology, the sociology of work and professions, and health policy and implementation. Her contribution in these fields has been to explicate the different kinds of ‘work’ involved in forms of healthcare and the implications of this for the wider health system and health policy.
Currently, she is working on a number of writing and empirical projects that explore the intersections of public health (management of epidemiological risk) and primary care (responsive care) mentalities in the fields of prevention and community wellbeing. She is currently developing this through a collaboration with Dr Patrick Brown (University of Amsterdam) and others to explore and research the concept of ‘risk work’. They recently edited a special edition of Health, Risk and Society on this topic.
Alex Ruck Keene
(39 Essex Chambers and Kings College London)
Alex is an experienced barrister, writer and
educator. His practice is focused on mental capacity law (broadly defined) in which he is able to provide specialist advice and representation. He also writes extensively in the field, editing and contributing to leading textbooks and (amongst many other publications) the 39 Essex Chambers Mental Capacity Law Newsletter, the ‘bible’ for solicitors (and others) working in the area. Alex is a Wellcome Trust Research Fellow and a Visiting Professor at the Dickson Poon School of Law at King’s College London. He served as consultant to the Law Commission in their review of the deprivation of liberty safeguards and as legal counsel to the Wessely Review of the Mental Health Act.
Professor Hazel Kemshall
(De Montfort University)
Professor Hazel Kemshall
Professor of Community and Criminal Justice De Montfort University
Hazel Kemshall is currently Professor of Community and Criminal Justice at De Montfort University. She has research interests in risk assessment and management of offenders, effective work in multi- agency public protection, and implementing effective practice with high risk offenders. She has completed research for the Economic and Social Research Council, the Home Office, Ministry of Justice, the Scottish Government, and the Risk Management Authority.
She has numerous publications on risk, including ‘Understanding Risk in Criminal Justice’ (2003, Open University Press). She has completed three evaluations of multi-agency public protection panels for the Home Office (2001, 2005, 2007), and has researched polygraph use with sex offenders, and evaluated the public disclosure pilots in England and Wales.
She is the author of Understanding the Community Management of High Risk Offenders (2008) and co- author of Working with Risk: Skills for Contemporary Social Work (2013).
Dr Campbell Killick
Campbell Killick has a background in social work and training in the areas of disability, mental health and adult safeguarding. He is currently lecturing in social work at Ulster University in Northern Ireland where he contributes to undergraduate and post qualifying courses. Campbell is course director on the MSc in Professional Development in Social Work which supports practitioners and service users to complete literature reviews, research projects and dissemination activities.
Campbell’s research interests include assessment and decision making in adult and children’s services. He has published research findings in relation to adult safeguarding, professional decision making and assessment. Campbell has recently co-authored Assessment, Risk and Decision Making in Social Work: An Introduction part of the Sage Transforming Social Work Practice Series.
Scott Y.H. Kim, M.D., Ph.D.
(NIH Clinical Center)
Scott is currently a Senior Investigator in the Department of Bioethics at the Clinical Center, National Institutes of Health. Prior to coming to the NIH, he was professor of psychiatry and co-director of the Center for Bioethics and Social Sciences in Medicine, University of Michigan. He is an adjunct professor of psychiatry at the University of Michigan and an adjunct professor of neurology at the University of Rochester.
Scott is a psychiatrist and a philosopher. Clinically, he has worked as a consultation psychiatrist in general hospitals and as an outpatient general psychiatrist. His philosophical background is in Kant’s moral philosophy. But most of his work has been in bioethics; more information can be found at scottkimbioethics.org.
(King’s College London)
Sarah graduated from the University of Cambridge with a master’s degree in Mathematics in 1996, and from the University of Durham with a PhD in Hypercomplex Hyperbolic Geometry in 2003. She currently is a Visiting Researcher in the Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London. Her main research interests include risk related discourses and practices in secure and forensic psychiatric services, the quality of practice in the First Tier Tribunals for mental health and the development and application of digital technologies to deliberation in Health Technology Assessment.
(Essex Autonomy Project)
Wayne is Professor of Philosophy at the University of Essex, where he is a member of the Essex Human Rights Centre and Director of the Essex Autonomy Project, a research and public policy initiative focusing on the ideal of self-determination (autonomy) in the context of care (health care, social care, eldercare, psychiatric care, etc.). He also holds an honorary research position with the South London and Maudsley NHS Foundation Trust. He is the author of numerous research articles and reports focusing on issues concerning decision-making and mental capacity in the context of mental health care, and has been involved in policy formation both in the UK and abroad. From 2014-16 he led a team that supported the UK Ministry of Justice in preparation for the review by the United Nations of UK compliance with the United Nations Convention on the Rights of Persons with Disabilities. In 2018 he served on the Equality and Human Rights topic group for the Wessely Review of the Mental Health Act.
(University of Essex)
Danny is a PhD student at the University of Essex, where he is supervised by Professor Wayne Martin. His thesis is titled “Making Sense of Nonadherence to Psychiatric Treatments”. His research is broadly situated in the philosophy of psychiatry, but he is interested in using resources from a broad range of traditions and other disciplines including economics and law. He has also conducted research on risk and mental capacity with a particular focus on the use of “sliding scales”. Recently, Danny worked for the Open Innovation Team, a cross-government unit that brings together academics and policy-makers to develop evidence-based policy.
Prof. George Szmukler
(King’s College London)
George is a Psychiatrist and Professor Emeritus of Psychiatry and Society at the IoPPN, King’s College London. His research focuses on strategies for reducing compulsion and coercion in psychiatric care. A key interest is mental health law reform, particularly the development of non-discriminatory, generic legislation which would apply to all persons, regardless of the cause of the underlying disturbance of treatment decision-making. Past posts have included Dean of the Institute of Psychiatry, King’s College London (2001-2006); Medical Director of the Bethlem and Maudsley NHS Trust (1997-1999), then joint Medical Director of the South London and Maudsley NHS Trust (1999-2001); Visiting Professor in the Department of Sociology at the London School of Economics (2005-2014); Associate Director of the NIHR Mental Health Research Network, with lead responsibility for Patient and Public Involvement in research (2007- 2015). His most recent book, Men in White Coats, discusses involuntary treatment in the context of human rights.
Prof. Sir Simon Wessely
(King’s College London)
Simon Wessely studied medicine and history of art at Trinity Hall, Cambridge, and finished his medical training at University College Oxford, graduating in 1981. He obtained his medical membership in Newcastle, before moving to London to train in psychiatry at the Maudsley. He has a Master’s and Doctorate in epidemiology. He is a Foundation Senior Investigator of the National Institute for Health Research, and past President of the Royal College of Psychiatrists and the Royal Society of Medicine. In 2017 he was asked by the then Prime Minister to chair the Independent Review into the Mental Health Act, which was accepted by the government and is now the basis of the 2021 White Paper. He has over 800 original publications, with an emphasis on the boundaries of medicine and psychiatry, unexplained symptoms and syndromes, population reactions to adversity, military health, epidemiology and others. He founded the King’s Centre for Military Health Research, which is now the main source of information on the health and well- 5 being of the UK Armed Forces past and present and has been Civilian Consultant Advisor in Psychiatry to the British Army since 2001. He also has a long-standing interest in how both ordinary people and organisations react to adversity. Since 2013 he has been the Director of the Public Health England/NIHR Health Protection Research Unit into Emergency Preparedness and Response. This has meant a heavy involvement in our COVID19 research response, I addition to which he is also PI on the MRC/ESRC funded NHS Check, a major study of the impact of the pandemic on NHS staff health and well being.
Prof. Jens Zinn
(University of Melbourne)
Jens Zinn studied Sociology, Social Psychology and Political Science at the University of Saarland and the University of Bielefeld (Germany). He worked at the Collaborative Research Center Status Passages and Risks in the Life Course in Bremen (1995-99), the Collaborative Research Centre Reflexive Modernization in Munich (1999-02) and in the ESRC priority network Social Contexts and Responses to Risk at the University of Kent (2003- 08). Jens joined the University of Melbourne in 2009 as T.R. Ashworth Associate Professor in Sociology. He has founded a number of international research networks on the Sociology of Risk and Uncertainty (SoRU) within the European Sociological Association (2005) and the International Sociological Association (2006). In 2015 he was awarded the prestigious Friedrich Wilhelm Bessel award by the Alexander von Humboldt Foundation. In his most recent research, he has advanced theorizing on risk taking (2020: Understanding Risktaking, Palgrave) and he has explored discourse semantic changes of risk in a historical perspective (2020: The UK at risk, Palgrave; 2018: Risk in the New York Times, Palgrave).