Mental health legislation should respect decision making capacity

Capacity, consent, and mental health legislation: Time for a new standard?

“…Rosenman (1994, p. 560) argued that 'Mental 238 C N C N C N C N Doyal and Sheather (2005) under the England and Wales legislation, where a competent patient may refuse life-threatening treatment for a medical condition but be forced, even although they retain capacity, to accept treatment for a mental illness which is not life threatening could equally apply in New Zealand. Consent to treatment is currently given somewhat perfunctory recognition in the Mental Health (Compulsory Assessment and Treatment) Act (1992) with the requirement to obtain consent from committed patients able to be overridden at the discretion of a second psychiatrist's opinion.…”

Capacity legislation for Ireland: filling the legislative gaps

“…The champions of this approach tend to come from a purely ethical standpoint 30 while those who oppose it are grounded in clinical practice. 31 This document raises the possibility that in future all mental health legislation may essentially be capacity legislation and the statutory roles which have been uniquely vested in doctors may be vested in other professions also.…”

The Oxford Handbook of Psychiatric Ethics, Volume 1

“…Justifications of this kind of approach refer to impaired insight in mental disorder (Saddichha 2008); to mental disorder removing autonomous control (Doyal and Sheather 2005); to the association of mental illness with global irrationality (discussed in Hewitt 2010); and to the idea that mental disorder undermines personal identity (Edwards 2010;Matthews 2000) or diachronic agency (Janssens et al 2004). Whatever the underlying assumptions, law that bases interference on the presence of mental disorder-the so-called "status" approach-holds that a psychiatric diagnosis eliminates the need to assess the person's decision-making ability.…”