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An analysis of patient autonomy within the British mental health system

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  1. Introduction
  2. An ethical dilemma
  3. Should the patient be given ECT or not?
    1. Kate's interview with the consultant psychiatrist involved in her care
    2. His decision to use ECT treatment
  4. The modern Human Rights movement
  5. The justifications for a paternalistic approach
  6. Justice fairness and equality
  7. The teams debate on Kate's treatment
  8. The service received by Kate
  9. Conclusion
  10. Bibliography

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.

[...] 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 a strive for excellence by the author. [...]

[...] As ECT had been identified as a reasonable prognosis to her diagnosed condition, the justice principle would seek to ensure she the does receive treatment. The policy questions about justice in health care rationing can be seen in the work of Daniels,(1985) who has extended Rawls's (1971)clear theory of justice to apply to the health care system. Daniels advocates a general theory according to which the health care system should be designed so as to bring everyone as close as possible to a decent minimum level of health, which he refers to as "normal species functioning". [...]

[...] 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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