scholarly journals Best interests and the raison d’être of health care

2015 ◽  
Vol 34 (4) ◽  
pp. 271-273
Author(s):  
V. Riordan
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Rights ◽  
Intrinsic Value ◽  
Best Interests ◽  
Expert Group ◽  
Best Interest ◽  
Instrumental Value ◽  
Mental Health Act ◽  
The Individual

The report of the expert group on the review of the Mental Health Act has recommended that the requirement to consider the best interests of the person be replaced by a list of guiding principles, which focus on the autonomy of the individual. The implied rationale for this is that acting in our patients’ best interests may be a violation of their human rights. Dignity is being proposed as an alternative way of capturing ‘the positive aspects associated with best interests’, but it is not clear how dignity is preferable to best interests. Both approaches may help protect the most vulnerable from exploitation. However, unlike best interests, dignity can be used as a synonym for autonomy. Valuing autonomy as a means to an end (instrumental value) should be distinguished from valuing autonomy as an end in itself (intrinsic value). As the ultimate end of instrumental autonomy is invariably the person’s best interests, abandoning that principle renders instrumental autonomy obsolete, leaving intrinsic autonomy as the supreme value. As best interest, dignity and autonomy rarely conflict, the proposed changes may appear minor, but they are not. When such values do conflict, acting against our patients’ interests may become inevitable.

scholarly journals Involuntary status and mental capacity for treatment decisions under Sections 4, 3, and 57 of Ireland’s Mental Health Act, 2001: analysis and recommendations for reform

2021 ◽  
pp. 1-6
Author(s):  
Katherine Reidy ◽  
Brendan D. Kelly
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Mental Capacity ◽  
Best Interests ◽  
Health Law ◽  
Significant Progress ◽  
Mental Health Act ◽  
Human Rights Based Approach ◽  
Over Time ◽  
Made In

Although significant progress has been made in Irish mental health law in recent decades, the Mental Health Act, 2001 still falls short of properly protecting human rights. A consideration of human rights developments, both domestically and internationally, highlights the urgent need for reform. In this paper we consider Sections 4 (‘Best interests’), 3 (‘Mental disorder’) and 57 (‘Treatment not requiring consent’) of the 2001 Act and related recommendations in the 2015 Report of the Expert Group on the Review of the Mental Health Act, 2001, and suggest specific areas for reform. Just as medicine evolves over time, so too does our understanding of human rights and law. While embracing a human rights-based approach to the extent suggested here might be seen as aspirational, it is important to balance achievable goals with higher ideals if progress is to be made and rights are to be respected.

How the statutory health attorney provision in Mental Health Act 2016 (Qld) is incompatible with human rights

2020 ◽  
pp. 103985622096840
Author(s):  
Neeraj S Gill ◽  
Kathryn Turner
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Conflict Of Interest ◽  
Compulsory Treatment ◽  
Persons With Disabilities ◽  
Mental Health Act ◽  
The Will ◽  
United Nations Convention ◽  
Equal Recognition ◽  
The Individual

Objective: Mental Health Act 2016 (Qld ) (MHA 2016) includes many ‘less restrictive ways’ to minimise involuntary/compulsory treatment. One such measure, the statutory health attorney, has been adopted from the Powers of Attorney Act 1998 (Qld). This paper analyses the statutory health attorney provision against the human rights framework adopted by the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Method: The statutory health attorney provision was analysed against the CRPD article 12 (equal recognition before the law). Results: The statutory health attorney provision is not based on the will and preferences of the individual, is not free from conflict of interest and is not subject to the required safeguards. Conclusion: The use of a statutory health attorney brings mental health and physical health under the same provision (the fusion law/proposal). However, the statutory health attorney provision is not compatible with the contemporary human rights framework adopted by the CRPD.

scholarly journals Revising, reforming, reframing: Report of the Expert Group on the Review of the Mental Health Act 2001 (2015)

2015 ◽  
Vol 32 (2) ◽  
pp. 161-166 ◽  
Author(s):  
B. D. Kelly
Keyword(s):  
Mental Health ◽  
Best Interests ◽  
Expert Group ◽  
Bodily Integrity ◽  
Psychiatric Admission ◽  
Mental Health Act ◽  
Mental Health Legislation ◽  
Health Legislation ◽  
Community Facilities ◽  
Alternative Set

Involuntary psychiatric admission and treatment in Ireland is chiefly governed by the Mental Health Act 2001. The Irish government announced a review of the 2001 Act in July 2011, and the Report of the Expert Group on the Review of the Mental Health Act 2001 was published on 5 March 2015. The report, which constitutes advice to the Minister for Primary Care, Social Care (Disabilities & Older People) and Mental Health, presents 165 recommendations relating to virtually all areas of the Act. It recommends that ‘insofar as practicable, a rights based approach should be adopted throughout any revised mental health legislation’ and that the principle of ‘best interests’ should be replaced by an alternative set of principles as follows: ‘the enjoyment of the highest attainable standard of mental health, with the person’s own understanding of his or her mental health being given due respect; autonomy and self-determination; dignity (there should be a presumption that the patient is the person best placed to determine what promotes/compromises his or her own dignity); bodily integrity; and least restrictive care’. The Report presents a series of other recommendations aimed at increasing multi-disciplinary involvement in key decisions, promoting human rights and strengthening inspections of community facilities. Overall, the package of measures outlined in the Report is complex, interesting and worthy of debate.

scholarly journals Perceptions of Ghanaian traditional health practitioners, primary health care workers, service users and caregivers regarding collaboration for mental health care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomon Nyame ◽  
Edward Adiibokah ◽  
Yasmin Mohammed ◽  
Victor C. Doku ◽  
Caleb Othieno ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Rights ◽  
Primary Health Care ◽  
Service Users ◽  
Traditional Health ◽  
Healthcare Needs ◽  
Primary Health ◽  
Traditional Health Practitioners ◽  
Health Practitioners

Abstract Background In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships.

Role of Dignity in Mental Health Care: Impact on Ageism and Human Rights of Older Persons

2021 ◽  
Author(s):  
Debanjan Banerjee ◽  
Kiran Rabheru ◽  
Carlos Augusto de Mendonca Lima ◽  
Gabriel Ivbijaro
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Human Rights ◽  
Mental Health Care ◽  
Older Persons

Universal rights and mental illness in Ireland

2004 ◽  
Vol 28 (4) ◽  
pp. 114-116 ◽  
Author(s):  
Gavin Rush ◽  
Declan Lyons
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Human Rights ◽  
Best Practice ◽  
Amnesty International ◽  
Legal Obligations ◽  
Promotional Campaign ◽  
The Right ◽  
International Conventions

The human rights group Amnesty International has recently expanded the range of rights it promotes to include the right of persons with mental illness to enjoy the best available mental health care. The Irish section of Amnesty has launched a report and promotional campaign on the rights of persons with mental illness, using internationally recognised norms of best practice reflected in international conventions that generate binding legal obligations of the Irish state. The report is critical of piecemeal reforms and inadequate resourcing of mental health services, and calls for a more comprehensive implementation of the recommendations of domestic and international reports.

scholarly journals Reforming the Mental Health Act 1983: ‘Joined Up Compulsion’

2014 ◽  
Vol 1 (5) ◽  
pp. 5
Author(s):  
Philip Fennell
Keyword(s):  
Mental Health ◽  
Learning Disabled ◽  
Legal Framework ◽  
White Paper ◽  
Best Interests ◽  
Mentally Disordered ◽  
Mental Health Act ◽  
Risk Patients ◽  
The Government ◽  
Personality Disordered

<p>This article discusses the two volume White Paper <em>Reforming the Mental Health Act</em> issued by the Government in December 2000. The two volumes are separately titled <em>The New Legal Framework</em> and <em>High Risk Patients</em>. The foreword to the White Paper appears above the signatures of the Secretary of State for Health, Alan Milburn, and the Home Secretary, Jack Straw. This is heralded as an example of ‘joined up government’, and indeed one of the themes of the White Paper is the need for closer working between the psychiatric and criminal justice systems. The primary policy goal of the proposals is the management of the risk posed to other people by people with mental disorder, perhaps best exemplified in Volume One of the White Paper which proclaims that ‘Concerns of risk will always take precedence, but care and treatment should otherwise reflect the best interests of the patient.’ This is a clear reflection of the fact that the reforms are taking place against the background of a climate of concern about homicides by mentally disordered patients, whether mentally ill, learning disabled, or personality disordered.</p>

R (on the application of H) v London North and East Region Mental Health Review Tribunal [2001] EWCA Civ 415, Court of Appeal

2020 ◽  
Author(s):  
Thomas E. Webb
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Public Law ◽  
Mental Health Act ◽  
East Region ◽  
Human Rights Act ◽  
Human Rights Act 1998 ◽  
Court Of Appeal ◽  
Health Review

Essential Cases: Public Law provides a bridge between course textbooks and key case judgments. This case document summarizes the facts and decision in R (on the application of H) v London North and East Region Mental Health Review Tribunal [2001] EWCA Civ 415, Court of Appeal. This case concerned whether the language of ss 72–73 of the Mental Health Act 1983 could be read in such a way as to be compatible with the Human Rights Act 1998 (HRA), under s. 4 of that Act, or whether such an interpretation was not possible. In the latter case the court should consider making a declaration of incompatibility. This note explores s. 4 HRA declarations of incompatibility. The document also includes supporting commentary from author Thomas Webb

The law

2009 ◽  
pp. 459-498
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Compulsory Admission ◽  
Sexual Offences ◽  
Disability Discrimination ◽  
Mental Health Act ◽  
Assessment And Treatment ◽  
Human Rights Act ◽  
Disability Discrimination Act ◽  
Health Review

Mental Health Act 1983 460 Mental Health Act 2007 462 Compulsory admission to hospital for assessment and treatment 464 Emergency holding powers 466 Mental Health Review Tribunals 468 The Mental Health Act Commission 470 Sexual Offences Act 472 Disability Discrimination Act 2005 474 Human Rights Act ...

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