Published 22 July 2008, doi:10.1136/bmj.a917
Cite this as: BMJ 2008;337:a917

Letters

Mental capacity

Clarification of mental capacity and psychiatric admission

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

The editorial by Dawson makes some interesting points but two important issues need clarification.¹ He says that where a patient might be covered by the Mental Capacity Act 2005 or the Mental Health Act 2007, the clinician can choose which to apply. There are, in fact, guidelines supplied with the code of practice for the Mental Capacity Act 2005 (www.justice.gov.uk/guidance/mca-code-of-practice.htm), advising which is the more appropriate. Crucially, once a patient is detained under the Mental Health Act 2007 it effectively "trumps" many provisions of the Mental Capacity Act, including advance refusals of treatment.

Dawson later states that for the act to apply "the patient must not be refusing treatment." It is true that when a patient actively dissents from (psychiatric) treatment, the Mental Health Act would be more appropriate, but readers should not run away with the impression that the Mental Capacity Act only applies when someone agrees . . . [Full text of this article]

¹ John Hampden Unit, Stoke Mandeville Hospital, Aylesbury HP21 8AL

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