Published 22 July 2008, doi:10.1136/bmj.a899
Cite this as: BMJ 2008;337:a899

Letters

Mental capacity

Who decides on treatment for mental illness?

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

Owen et al have again stoked the controversy of who decides whether a person with mental illness should be treated.1 On the basis of rights of the mentally ill, every person should be able to refuse treatment. But mental illness is not like any other illness since insight into the illness is immediately affected with the onset of illness. One can very easily verify this with high levels of incapacity observed in all the forms of psychiatric illness where insight is poor—for example, schizophrenia, psychotic illness, and bipolar manic disorder. Once insight is affected, so is judgment. Who decides whether the person ought to be treated? As the authors themselves say, the answers are too complicated although the questions may be simple.

Owen et al cite references for the inter-rater reliability of the MacArthur competence assessment tool,2 3 4 5 but these are only for the original scale and not for the modified . . . [Full text of this article]

Sahoo Saddichha, senior consultant (WHO-BGI)

1 Kolkata, India

saddichha@gmail.com


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Relevant Article

Mental capacity to make decisions on treatment in people admitted to psychiatric hospitals: cross sectional study
Gareth S Owen, Genevra Richardson, Anthony S David, George Szmukler, Peter Hayward, and Matthew Hotopf
BMJ 2008 337: a448. [Abstract] [Full Text] [PDF]

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