Autonomy or life saving treatment for the mentally vulnerable?

doi:10.1136/bmj.b4400

Published 28 October 2009, doi:10.1136/bmj.b4400
Cite this as: BMJ 2009;339:b4400

Letters

Mental capacity

Autonomy or life saving treatment for the mentally vulnerable?

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

McLean is correct to suggest that "even the presence of mentalillness" is not a bar to the presumption of mental capacity.¹But she fails to mention that depression and emotionally unstablepersonality disorder are mental disorders, which often impaira person’s cognition and emotional health. Moreover, McLeanfails to emphasise that the mental capacity needed to make adecision to refuse life saving medical treatment is much higherthan that needed to refuse other forms of medical treatment.²It is difficult to see how a doctor (and subsequently a coroner’scourt) could come to the view that Kerrie Wooltorton was ableto "weigh" and "use" information given to her about treatmentand the consequences of refusing to accept treatment, if shewas mentally disordered as described.³

If mental disorder had been diagnosed, she could have been assessedfor detention under section 2 of the Mental Health Act 1983.It . . . [Full text of this article]

Fareed A Bashir, consultant forensic psychiatrist, Mike Crawford, consultant forensic psychiatrist

¹ Edenfield Centre, Prestwich Hospital, Manchester M25 3BL

fareed.bashir@gmw.nhs.uk