Intended for healthcare professionals

Rapid response to:

Observations Ethics Man

What to tell junior doctors about ethics

BMJ 2010; 340 doi: (Published 12 May 2010) Cite this as: BMJ 2010;340:c2489

Rapid Response:

Re: Re: Re: The payment of drug addicts to enforce sterilization

I thank Dr Morgan for his reply and providing the link on which he relies. As indicated, capacity to consent is a major issue if one is suffering from a mental disorder whether it is due to effects of drugs or some other cause. However, not all who have a mental disorder per Mental Health Act 1983 (as amended) lack the capacity to consent per Mental Capacity Act 2005; hence, some who're addicted to drugs could fall into this category. Of course, such clinical judgments should be made by appropriately approved/qualified professionals; there's no suggestion that this new venture would not rely on the opinions of such professionals where necessary.

So is Dr Morgan arguing that a drug addict who shows evidence of mental disorder, though has the capacity to consent, should not be offered financial incentives for contraception as it would be unlawful to do so? Or is Dr Morgan suggesting that their consent would in any event be invalid purely because drugs addicts are a vulnerable group? If there's no financial incentive whatsoever, but such measure is purely in the best interest of the person concerned, then what would be Dr Morgan's view? Also, I wonder what Dr Morgan's position would be if an addicted person has come-off drugs following a period of treatment, no evidence of mental disorder and there's no issue as to her mental capacity either? Finally, I apologise to Dr Morgan for a posing a number of questions on this matter.

Competing interests:
None declared

Competing interests: No competing interests

14 June 2010
Jay Ilangaratne