6,7,8 July 2017
Our 2017 Autonomy Summer School will be held at the Colchester Campus of the University of Essex. The theme of the Summer School is Objectivity, Risk and Powerlessness in Care Practices.
During the three days we’ll cover issues around objectivity and evidence, coercion and control, risk in the practice of care and support for decision-making. There will also be updates for practitioners on the UNCRPD and the Law Commission. This year we’re also pleased to welcome colleagues from the Ethics of Powerlessness project who will be leading sessions on day two of the Summer School. They have been working with care practitioners in the palliative care and hospice specialism and will be teaching sessions on the phenomenology of powerlessness and countering powerlessness in care settings.
Teaching on the Summer School will be led by Wayne Martin, Fabian Freyenhagen and Matt Burch from the Essex Autonomy Project, Alex Ruck Keene, from 39 Essex Chambers, and Beatrice Han-Pile, Dan Watts and David Batho from the Ethics of Powerlessness project.
The Summer School will be multi-disciplinary, will combine briefings on theory and applications to practice and will give delegates many opportunities to discuss the challenges of delivering care in a framework that supports and empowers individuals. We welcome practitioners in social work, law, medicine, psychiatry, as well as policy makers, students and academic researchers – in fact anyone who shares our interest in cultivating respect for the autonomy of recipients of care.
The fee for the Summer School is £475. This includes three nights bed and breakfast accommodation at the University of Essex, lunch on each day of the Summer School, plus all teaching and reading materials. Places on the Summer School are limited in number.
If you have any questions about the Summer School please email firstname.lastname@example.org.
Thursday 6th July
Objectivity and Evidence: We expect legal findings to be evidence-based and objective, but what does objectivity actually entail and does it mean different things to different people? What concept of objectivity is best suited for regulating and assessing mental health care policies and practices? Are we sure that objectivity is the right ideal in this arena?
Coercion and Control: There is a significant cohort of individuals who do not lack capacity under the MCA and are outside the scope of domestic violence legislation, but are in some way vulnerable to coercion or duress. Many, but not all, of these individuals have cognitive or other impairments and although local authorities in England and Wales have a statutory duty to inquire into the situation, at present it is unclear what steps can be taken to secure the protection of these vulnerable adults. Is this an area ripe for law reform, and, if so, what principles should govern such reform?
Law Commission Update
Friday 7th July
Phenomenology of Powerlessness: Patients, carers, and practitioners of health care often report experiences of powerlessness. But what is it to experience oneself to be powerless? In this session, we shall analyse case studies drawn from empirical reports using the tools of phenomenology, and discuss the nature of experiences of powerlessness, both in relation to the self and to others. Do experiences of powerlessness have shared features? Are they necessarily negative experiences?
The Power to be Oneself: A woman who can no longer care for her grandchildren may find that she can no longer be a grandmother. A man whose chronic illness prevents him from going to work may find that he can no longer be a manager. A woman who is prevented from providing the care she deems appropriate may find herself unable to be a nurse. In these ways and others, experiences of powerlessness are marked by the experience of the loss of the power to be oneself. In this session we shall focus on this phenomenon. What is the power to be oneself? How is it distinct from the power to do something? What is the importance of the power to be oneself in everyday life? Can it be recovered, and if so, how?
Support for Decision-Making: CRPD Art 12.3 requires all states parties to provide support to persons with disabilities in the exercise of their legal capacity. The “second principle” of the Mental Capacity Act (England and Wales) is in effect a promise by the state to provide practiable support for persons to make decisions for themselves wherever possible. A whole section of the Northern Ireland MCA is devoted to filling out the terms of the promise of support. The Republic of Ireland has an Assisted Decision-Making (Capacity) statute. But delivering on the promise of support for decision-making requires more than noble words in legislation. It requires innovations in practice. We review legal and research developments in this area, and tackle some challenging hard cases to consider how support can best be provided.
Insight: The Essex Autonomy Project has just embarked on a research project investigating the role of insight in clinical decision-making. A significant variable among recipients of mental health care is the phenomenon known as insight. A patient who shows awareness of the fact that he is unwell is described as having insight; patients without that awareness are said to lack insight. The presence or absence of insight shapes the clinical encounter. From the physician’s perspective, absence-of-insight is a palpable clinical reality, but from a legal perspective, the concept is fraught with difficulty. But what exactly is insight, and how does it manifest itself in different patient populations? How should it be defined and conceptualised?
Saturday 8th July
The Theory of Risk and the Practice of Care: The dominant paradigm in today’s discourse on risk stems from decision theory. This discipline has developed excellent mathematical tools for decision-making under risk. However, these tools are only powerful predictors of risk under certain conditions – conditions almost never met in care work. Care workers are not like insurance actuaries setting policy prices. They work collaboratively with individuals to solve specific problems in environments where the accurate statistical forecasting of risk is not a real possibility. What would a concept of risk suited to the care setting look like? And what would be the implications of such a concept for practice?
UNCRPD Update – What Practitioners Need to Know
Will and Contract: Participation in modern social life is mediated at every turn by contracts. The bus ticket I use to get to work is a contract; my employment is based on a contract; so is my accommodation, my access to modern communication devices, even my marriage. Access to contract is therefore a critical part of access to full participation in social and community life. But for persons living with disabilities or impairments of decision-making ability, access to contracts can present a minefield. Such individuals may find themselves denied access to contract altogether based on a legal finding of incompetence. Or they may be exposed to exploitative contracts. They may find themselves on the receiving end of discriminatory practices. We will survey this fraught territory and consider both some basic questions about what contracts are, some history of the right to contract, and the challenge of ensuring “respect for rights, will and preferences” in contract law and practice affecting persons with impaired decision-making abilities.