About BABEL

The interdisciplinary BABEL project explores healthcare decisions for individuals who are deemed to be unable to make decisions for themselves. When someone is considered to lack what the law calls ‘mental capacity’ or ‘competence’, then decisions must be made in their 'best interests'.

Best interest decisions may be made concerning children – as poignantly illustrated in the widely-publicised legal case of Charlie Gard – and adults, including those with learning disabilities, dementia or prolonged disorders of consciousness.

BABEL asks how the 'best interests' of such patients should be understood – which factors and values should be considered, who should be involved, and indeed whether ‘best interests' is even the best approach.

BABEL is led by Professor Richard Huxtable, and the project team comprises Professor Judy Laing, Professor Sheelagh McGuinness and Dr Aoife Finnerty from the Centre for Health, Law and Society (CHLS), and Professor Jonathan Ives, Dr Giles Birchley and Dr Emanuele Valenti from the Centre for Ethics in Medicine (CEM).

This project substantially builds on work already conducted by CEM and CHLS, including on a Wellcome Trust funded Seed project, and is supported by a broad multi-disciplinary team of researchers, patients and professionals from Bristol and beyond.

The £1.5 million grant funds a 5-year programme of work, across four distinct workstreams, and includes PhD studentships, a visiting fellow scheme, and a programme of public engagement work.

Research Questions

BABEL seeks to answer the following three research questions:

Research question 1:  What is the nature and purpose of the best interests standard (BIS) in medico-legal decision-making?

Research question 2: How does the best interests standard currently operate in medico-legal decision-making?

Research question 3: How should the best interests standard operate in medico-legal decision-making?

BABEL Cloverleaf representing four areas: best interests in healthcare ethics, healthcare law, empirical bioethics and theory, practice and relation.

We are absolutely thrilled that the Wellcome Trust has chosen to support this important project. Best interests decisions are taken daily for thousands of patients and we hope, through our five years of work, to help support and inform everyone involved, from patients to carers to professionals

Professor Richard Huxtable, Director CEM, BABEL Director

Study Design

BABEL is an interdisciplinary project that draws on a range of different methods of data collection and analysis, comprising both empirical and theoretical components.  This requires an approach to research methodology that is able to integrate different kinds of data and synthesise different kinds of analysis.

Although BABEL adopts this broad orientation, specific approaches to specific questions will be developed within each workstream.

Richard, Jon, Giles and Emanuele work on WS1, which is exploring the perspectives of health professionals, patients, and those close to them. We involved various members of the public, as well as people with lived experience of “best interests” decisions, in discussions about planning and designing the BABEL project. In particular, members of the BABEL project team had meetings with people from the following groups:

We’re very grateful to everyone who met with us to discuss the project and who contributed to the design of the project.

Previously involved with the BABEL team

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