Published 15 June 2009, doi:10.1136/bmj.b2430
Cite this as: BMJ 2009;338:b2430

Letters

Deprivation of liberty

Liberty safeguards in hospital

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

The interplay of deprivation of liberty safeguards and the Mental Capacity Act is probably most complex in general hospitals.1 People with delirium, dementia, or severe aphasia or who are in coma will lack the capacity to consent to admission or prolonged stay because of their underlying cognitive state.2 Delirium and other neuropsychiatric disorders are often subject to chemical restraint in general hospitals, especially in adult critical care units.3 Such restraint is done in a patient’s best interest but could be regarded as deprivation of liberty under the Mental Capacity Act.

In managing a patient who has delirium in a general ward or intensive care, doctors may need to consider the use of the amended Mental Health Act 2007. However, this may not be immediately possible in an emergency—for example, the patient suddenly becoming aggressive and unmanageable. If a patient experiences repeated episodes of aggression/agitation alternating with lucid intervals, repeated use . . . [Full text of this article]

Nitin Gupta, consultant psychiatrist1

1 South Staffordshire and Shropshire Healthcare NHS Foundation Trust, Margaret Stanhope Centre, Burton on Trent DE13 0RB

nitingupta659@yahoo.co.in


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