Mental health legislation should respect decision making capacity

doi:10.1136/bmj.331.7530.1467

BMJ 2005;331:1467-1469 (17 December), doi:10.1136/bmj.331.7530.1467

Education and debate

Mental health legislation should respect decision making capacity

Len Doyal, emeritus professor of medical ethics¹, Julian Sheather, senior ethics adviser²

¹ Barts and The London School of Medicine and Dentistry, Queen Mary College, University of London, London E1 2AD, ² Medical Ethics Department, BMA, London WC1H 9JP jsheather@bma.org.uk

New legislation should raise the moral standards of professionaland personal life, but the proposed new mental health bill failsto deal with serious ethical problems in the existing act

The first 150 words of the full text of this article appear below.

Introduction

The government is introducing new mental health legislationin England and Wales. Critics have argued for some time thatthe 1983 Mental Health Act is outmoded, unable to provide theflexibility required after changes in psychiatric practice andsocial attitudes towards mental illness. Case law has also shownthat the act has to be changed to ensure compatibility withhuman rights legislation. A draft bill was published in September2004,¹ and, after a report by a cross-party scrutiny committeein March 2005,² the government announced its intention to introducea new bill in autumn 2005. Concerns have been raised, however,by both user and professional groups about both the Mental HealthAct and the draft legislation. The most serious of these isthe lack of respect for the autonomy of mentally ill people,which we believe strikes at the heart of the legislation's morallegitimacy.

Autonomy

Concerns about autonomy can be . . . [Full text of this article]

Effect of mental illness on patient autonomy

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Equality and the problem of consent

Conclusion

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Rapid Responses:

Read all Rapid Responses

Respecting patients rights extends beyond autonomy.: Marion Y Gray
bmj.com, 16 Dec 2005 [Full text]
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Therapeutic benefit should be at the heart of any mental health legislation.: Mokhtar G E K N Isaac
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