Hazel McHaffie

Questions & Challenges for “Vacant Possession”

Literary questions for reading groups

For discussion
  • Q. Bill Faraday is the central character in the first part of this book; Geoff Archibald takes over. To what extent does this development influence the story?
  • Q. Neither Viv nor Rhona can contribute to the debate. How real are their characters viewed through the eyes of their relatives?
  • Q. Frances Faraday is seen as someone who is less than honest. How does her religious life square with this trait?
  • Q. How compatible do you feel Rhona and Geoff Archibald were before her suicide attempt?
  • Q. Why do you feel Geoff chose to keep his suspicions from the police for as long as he did? Were his scruples justifiable in the circumstances?
  • Q. Bill comes in for strong criticism. Do you think he was a good father?
  • Q. How big a part does deception play in this book?

Moral and ethical questions

Vacant Possession revolves around the central theme of decision making on behalf of the mentally incompetent.

Proxy decision making
  • Q. Dr Steven Wilkinson says that it is his responsibility to decide what should be done for Viv Faraday but he looks to the family to guide him as to Viv’s own wishes when she was competent to decide.
    1. To what extent should the family influence medical decisions?
    2. Is there a moral difference between a decision about abortion and a decision about other forms of medical intervention?
  • Q. Geoff Archibald, and Bill, Frances, Kevin and Euan Faraday all contemplate abortion on behalf of their female relatives who are no longer able to state their own wishes.
    1. Should parents, husbands and/or siblings of the mentally incompetent patient have equal rights to contribute to the decision making process?
    2. If not, whose voice should take precedence in the event of conflict?
    3. Bill Faraday considers Viv’s mother and brothers have forfeited their right to a voice because of ‘desertion’. Is he right?
    4. Should a social father have the same rights to a voice in decision making as a biological father?
  • Q. Neither Viv nor Rhona specifically contemplated persistent vegetative state or rape prior to lapsing into a comatose state. How far is it relevant to extrapolate their preferences from their stated views on related topics?
  • Q. Dr Charles Wynne-Hope says ‘I can’t make good decisions if I don’t care about the patients – if I’m not touched by the effect on the families.’ How far should medical personnel allow their emotions to enter into decision making?
Rights and interests
  • Q. Does Viv’s unborn child have any rights in the circumstances recounted in Vacant Possession?
  • Q. In the decision about whether or not to abort her fetus, Euan Faraday believes that Viv is not the only member of the family who counts. Is he right? If so, who else should be counted and on what grounds?
  • Q. Rhona Archibald knows nothing and may be said to have no interests of her own except in so far as they affect others. Can Geoff legitimately ignore what would be her interests if she were mentally competent and aware where these conflict with his own?
  • Q. Bill has his own private reasons for withholding consent to DNA testing. DS Latimer tells him the law can overrule his refusal. Given all the circumstances should this be permissible?
Disclosure of information
  • Q. Geoff is infuriated by his GP’s unwillingness to share with him information about Rhona which might help him to understand why she attempted to end her life. However, the doctor does agree to divulge confidential information to the medical team caring for her now. Is the GP’s position ethically defensible?
Competence to decide
  • Q. Ten-year-old Ginny is facing a second bone marrow transplant for a recurrence of her leukaemia. Frances Faraday argues that she is not competent to decide for herself whether or not to undergo the procedure.
    1. Should such a child be allowed to i) accept or ii) refuse such a procedure?
    2. Is there a moral difference in deciding for a course of action which will end in death as distinct from one which offers a hope of life?
    3. Does it take a higher level of competence to decide to forgo rather than accept treatment for a potentially fatal illness?
    4. Would the eventual outcome of such a decision influence your argument?
Respect for autonomy
  • Q. Respect for autonomy involves letting competent adults choose for themselves even when their decisions may involve harmful consequences, Dr Wilkinson tells the Faradays. Is this an appropriate delegation of responsibility? Under what circumstances should doctors be permitted to overrule patients/relatives’ decisions?
Conflicts between ethical principles
  • Q. News of a rape in Chivenings could have a potentially disastrous effect on the management and future of the Home.
    1. Would Dr Steven Wilkinson be justified in keeping the information quiet to prevent adverse reactions?
    2. Is it ever ethically acceptable to sacrifice the good of the individual in the interests of the many?
  • Q. Dr Steven Wilkinson faces a situation where it appears a rapist is loose in his Home. He briefly contemplates putting the female patients on contraceptives to prevent further pregnancies. Could such a decision be morally justified?
  • Q. Is it ever ethically defensible to sterilise a mentally incompetent patient to avoid the risk of pregnancy?
  • Q. In Geoff’s mental rehearsal of the arguments, the judge suggests that it is a waste of courtroom time and taxpayers’ money to debate the issues for an insentient woman. Resources should rather be diverted to ensure legal representation for mentally competent but distressed victims of violent assault. Is he right?