Being subject to Section three of the Mental Health Act 1983 removes some rights taken for granted by members of today's society. Patients subject to this Mental Health Act may find it difficult to exercise the right of autonomy, and furthermore face many ethical dilemmas whilst under a Mental Health Section. This paper aims to identify and reflect on such a situation witnessed by a second year mental health student whilst on placement at an intensive support psychiatric unit.
It will analyze the legal and ethical dilemma, and relate theory to practice in the context of medical ethics. The principles of Autonomy, beneficence, and justice will be raised and a rational for these theories will be interpreted, based around the dilemma of treatment without consent.
[...] It would be only too easy to adopt regimented procedures in heretic from the Victorian era of mental health nursing, and forcibly treat patients with medication or arguably, methods of extreme treatment programs. It is necessary at times to have to establish the ethical rights of the patient versus the paternalistic approach of the service providers when considering the best treatment required. It is equally important to establish the needs of the patient and establish the benefits of not treating against the loss of any further therapeutic privilege, if forced treatment is to be executed. [...]
[...] Under the terms of the Mental Health Act, Section fifty-eight, he had a duty to call for a second opinion doctor. A detailed explanation of this act is found at the Department of Health and Welsh Office (1990). Medical ethics define autonomy as the right of the patient to decide what will happen to one self. The Human Rights Act sometimes comes into conflict with medical ethics especially in the mental health setting. The modern Human Rights movement developed in the aftermath of systematic Nazi atrocities in World War II. [...]
[...] To have the privilege of autonomy in the health care setting, Schneider (1998) suggests that the patient must be able to present themselves in a manor that is competent to make an informed choice, further more Gillon, (1986) cited in Rumbold (1999), stated that they must have the capacity to think and act on the basis of such thought and freely and independently, without let or hindrance. This is supported by the written guidelines and codes to which the healthcare professional must subscribe, Nursing Midwifery Council code of ethics (2002). [...]
[...] Whilst living in the comfort of the mental health act to force treatment where necessary, we should endeavor to gain an acceptance for treatment in an effort to promote therapeutic privilege. The relevant theories of ethics have been identified and discussed and the legal implications of the event explored. It is acknowledged that ethical dilemmas are a common in the field of Psychiatric nursing and involvement and exposure to similar events will support the desire for striving for excellence by the author. [...]
[...] The dilemma discussed identifies the situation where a patient under section three of the Mental Health Act has been recommended for Electro Convulsive Therapy (ECT) in a view to address her deteriorating mental condition. The patient has in the first instance declined having this treatment, and the dilemma exists: “Should the patient be given ECT or NOT Kate is a 21-year-old patient that presents to the service with a diagnosed condition of schizophrenia. She has spent the last three years in and out of the inpatient service on Section three of the Mental Health Act due to many periods of relapse and breakdowns at numerous placements. [...]
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