Mental health legislation and decision making capacity: Capacity is of more than practical benefit

doi:10.1136/bmj.332.7533.119-a

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Brian J Murray, consultant psychiatrist, older adult (brian.murray@bmh.nhs.uk)

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

Editor—Doyal and Sheather's suggestion to base mental health legislation on capacity is bold and timely, but Chiswick's commentary misses the point.1 Freedom to choose assumes the ability to make choices, or autonomy and decision making capacity are synonymous. The principle of autonomy is enshrined as the highest possible biomedical principle, trumping all others.2

Common law allows enforced treatment only because in certain situations patients are considered to have lost …