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Commentary: “I’ve lost count of the times my door has been broken by the police”

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j1165 (Published 15 March 2017) Cite this as: BMJ 2017;356:j1165

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Re: Commentary: “I’ve lost count of the times my door has been broken by the police”

I also (agreeing with Simon Kenwright's response of 20 March) would be interested in an 'audit' of such welfare checks.

It was certainly historically true, that with respect to 'best interests' our courts applied 'concern about “preservation of life” trumping all else'. But this is no longer the case - see for example the ruling by Mr Justice Charles about the withdrawal of CANH (see ref 1) and some of the court rulings I discuss in reference 2.

The problem, seems to be that some people do wish to be 'safeguarded': they are aware of their own mental health problems, and when less-affected by what I shall call 'periods of poor decision-making' those people would effectively request this 'safeguarding'. But other people, know they are careless of their own health and safety, but neither wish to be 'safeguarded' nor are they legally 'lacking in mental capacity' [nor demonstrably afflicted by a mental illness which is affecting their decision-making].

On the front-line, professionals seem to find it easier to 'safeguard first, and justify the intervention later': but, if that is out-of-line with legal rulings, and it probably is out of line with recent legal rulings, the behaviour appears to be flawed. However, especially as the media invariably spotlight cases where 'safeguarding has gone wrong', it is not at all obvious how to achieve behaviour which is properly-balanced between respecting 'the right of the careless but unusual capacitous individual who is reckless [with his/her own health] or even deliberately self-destructive' and 'protecting the individuals who we should be protecting'.

I strongly suspect, that the balance at present is distorted towards the protection of the people charged with doing the safeguarding.

But I have no good idea(s), as to how to remove that distortion.

Ref 1 http://www.bmj.com/content/355/bmj.i6829/rr-0

Ref 2 http://www.dignityincare.org.uk/Discuss_and_debate/Discussion_forum/?obj...

Competing interests: No competing interests

20 March 2017
Michael H Stone
Retired Non Clinical
None Private Individual
Coventry CV2 4HN

What is the alternative?

A full formal audit of these welfare checks by the police would interesting. I have heard how they can be frightening, burdensome and inappropriate. The victim does not have to be ill, physically or mentally, nor does the person informing the police have to be one of the caring professions. At least here it is the GP who seems to have put the wheels in motion. In some instances it may just be an anxious neighbour – and perhaps acting from questionable motives – and the victim essentially a somewhat frail and elderly person who has chosen to live alone.

As with doctors, the police too seem at times to be able to exonerate themselves by claiming to act in “best interests” with concern about “preservation of life” trumping all else. But is there an alternative that a Society that likes to see itself as caring - whatever the reality - would see as acceptable?

Competing interests: No competing interests

20 March 2017
Simon Kenwright
Rtd Physician
Stowting, Ashford KENT
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