Ethical and Human-Rights Issues in Research on Mental Disorders That May Affect Decision-Making Capacity

1999 ◽  
Vol 340 (18) ◽  
pp. 1430-1434 ◽  
Author(s):  
Alexander Morgan Capron
Keyword(s):  
Decision Making ◽  
Human Rights ◽  
Mental Disorders ◽  
Decision Making Capacity ◽  
Rights Issues

scholarly journals Residence capacity: its nature and assessment

2015 ◽  
Vol 21 (5) ◽  
pp. 307-312 ◽  
Author(s):  
Julian C. Hughes ◽  
Marie Poole ◽  
Stephen J. Louw ◽  
Helen Greener ◽  
Charlotte Emmett
Keyword(s):  
Decision Making ◽  
Human Rights ◽  
Mental Disorders ◽  
Intellectual Disabilities ◽  
Mental Capacity ◽  
Basic Information ◽  
People With Dementia ◽  
The Individual

SummaryThis article discusses the importance of residence capacity – an individual's mental capacity to decide where they should live – and suggests how it should be assessed. People with dementia or intellectual disabilities, as well as those with other mental disorders, are sometimes required to make this decision. Assessments of capacity must be conducted with considerable care, given the implications for the individual and for their human rights. The assessment must be objective and functional: the assessor must be able specifically to demonstrate a lack of decision-making ability. Yet assessments of capacity still require evaluative decisions to be made. We suggest some basic information that should be conveyed to the person faced by the prospect of a change of residence where there is a doubt about capacity.

scholarly journals 6 The Intersection of Human Rights and Decision Making Capacity Legislation with Person Centred Approaches

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Amanda Phelan ◽  
Patricia Rickard Clarke
Keyword(s):  
Decision Making ◽  
Human Rights ◽  
United Kingdom ◽  
Social Care ◽  
Self Determination ◽  
Cognitive Capacity ◽  
Risky Decision ◽  
Support Person ◽  
Decision Making Capacity ◽  
Health And Social Care

Abstract Background A major focus on decision making capacity (as opposed to cognitive capacity and competence) legislation in many Western countries is the integration of a human rights approach focused on self-determination and autonomy. This paper examines modern day concepts of personhood and person centred care and presents Irish and United Kingdom legal commentaries which focus on health services’ and society's approaches to risky decision making. Integrating human rights into decision making capacity legislation has been central in contemporary discourses on health and welfare. Methods A literature review was undertaken charting the emergence of personhood, person centred care and human rights. Case studies of influential legal commentaries in Ireland and the United Kingdom where decision-making capacity was addressed were mapped to person centred care principles. Results Findings point to a convergence of discourses of human rights in contemporary approaches to health and social care as well as the evolution of legislation to support person centredness in fostering safeguarding and promoting autonomy and self-determination. Specific legal commentaries point to the need of health and social care to be mindful of paternalism and to conceptualise the concept of ‘risk’ with a particular emphasis on the inclusion and defence of the voice of the older or vulnerable person. Conclusion The intrinsic worth of each human is articulated through an implicit and explicit vindication of their human rights. The emergence of the third generation of human rights has argued the value of self-determination and autonomy, articulated through robust national legislation on decision-making capacity based on the core principles of person centred care approaches. This move from paternalism is imperative and is imbued in contemporary legislation and legal commentaries, which has noted the need for revisions in health and social care case management perspectives.

scholarly journals Education versus screening: the use of capacity to consent tools in psychiatric genomics

2019 ◽  
Vol 46 (2) ◽  
pp. 137-143
Author(s):  
Camillia Kong ◽  
Mehret Efrem ◽  
Megan Campbell
Keyword(s):  
Decision Making ◽  
Human Rights ◽  
Intellectual Disability ◽  
Informed Consent ◽  
Mental Disorder ◽  
Screening Tools ◽  
Relational Autonomy ◽  
Decision Making Capacity ◽  
Genomics Research ◽  
Ethical Tension

Informed consent procedures for participation in psychiatric genomics research among individuals with mental disorder and intellectual disability can often be unclear, particularly because the underlying ethos guiding consent tools reflects a core ethical tension between safeguarding and inclusion. This tension reflects important debates around the function of consent tools, as well as the contested legitimacy of decision-making capacity thresholds to screen potentially vulnerable participants. Drawing on human rights, person-centred psychiatry and supported decision-making, this paper problematises the use of consent procedures as screening tools in psychiatric genomics studies, particularly as increasing normative emphasis has shifted towards the empowerment and participation of those with mental disorder and intellectual disabilities. We expound on core aspects of supported decision-making, such as relational autonomy and hermeneutic competence, to orient consent procedures towards a more educative, participatory framework that is better aligned with developments in disability studies. The paper concludes with an acknowledgement of the pragmatic and substantive challenges in adopting this framework in psychiatric genomics studies if this participatory ethos towards persons with mental disorder and intellectual disability is to be fully realised.

Migration and the SDGs

2017 ◽  
Vol 17 (2) ◽  
pp. 231-238 ◽  
Author(s):  
Nicola Piper
Keyword(s):  
Decision Making ◽  
Human Rights ◽  
Development Policy ◽  
National Level ◽  
Decent Work ◽  
Key Factors ◽  
Global Migration ◽  
Migration Pathways ◽  
First Time ◽  
Rights Issues

International migration has been subject to rising attention by policymakers at the global as well as national level, thus, amounting to ‘global migration governance’. The flurry of multi-lateral actions and regional activities have revolved around two interlinked concerns: 1. Management of migration, and 2. The migration-development nexus. Migrant rights issues have not been absent from these debates but are generally sidelined or appear in the context of extreme forms of human rights violations such as trafficking. The SDGs, by contrast, not only for the first time incorporate migration explicitly into global development policy, but they also have the potential to address the key factors that underline migration from a rights perspective if – as argued here - their realisation goes beyond the provision of ‘safe and orderly migration’ pathways to also address the lack of ‘decent work’ and participatory decision making from a (gendered) workers’ rights perspective at all stages of migration.

Psychiatric research

2021 ◽  
pp. 351-380
Author(s):  
Laura B. Dunn ◽  
Laura Weiss Roberts
Keyword(s):  
Decision Making ◽  
At Risk ◽  
Informed Consent ◽  
Mental Disorders ◽  
Ethical Issues ◽  
Psychiatric Research ◽  
Substantial Body ◽  
Decision Making Capacity ◽  
Human Volunteers ◽  
Potential Sources

The ethical engagement of human volunteers is critical to advancing research on mental disorders. The symptoms and impairments commonly associated with psychiatric disorders nevertheless raise numerous issues about the ethical dimensions of research involving people at risk for, living with, and suffering from these disorders. A substantial body of literature now exists addressing both conceptual and empirical issues related to ethical dimensions of psychiatric research. While much of the discussion of ethical issues in research has focused on informed consent and decision-making capacity, additional relevant issues also warrant consideration. These include influences on participants’ decisions about enrolling in research, potential sources of vulnerability, and investigator integrity. This chapter provides an overview of these topics, describes two frameworks for analysing the ethical dimensions of research, and utilizes case illustrations to highlight some of these issues.

scholarly journals Providing treatment to prisoners with mental disorders: development of a policy

2003 ◽  
Vol 182 (4) ◽  
pp. 299-302 ◽  
Author(s):  
Mark Earthrowl ◽  
John O'Grady ◽  
Luke Birmingham
Keyword(s):  
Decision Making ◽  
Mental Disorders ◽  
Psychiatric Hospitals ◽  
Treatment Decision ◽  
Case Law ◽  
Care Staff ◽  
Best Interests ◽  
Health Care Staff ◽  
Ethical Implications ◽  
Decision Making Capacity

BackgroundMental disorder is more prevalent among people in prison than in the general population. Prisoners who require transfer to psychiatric hospitals for treatment face long delays. Doctors working in prisons regularly face ethical and legal dilemmas posed by prisoners with mental illness.AimsTo develop a policy for providing treatment under the common law to prisoners with mental disorders who lack treatment decision-making capacity while arrangements are made to transfer them to hospital.MethodThe policy was developed through literature review and consultation with the Faculty of Law at Southampton University and health care staff at Winchester prison in the UK.ResultsThe policy provides guidelines for establishing decision-making capacity standards for documentation, and guidelines for implementation based on the Mental Health Act Code of Practice, other best-practice guidelines and case law.ConclusionsIt can be argued that case law allows more-extensive treatment to be provided in the best interests of the incompetent prisoner, beyond emergency situations. The policy has ethical implications and its use should be carefully monitored.

scholarly journals Capacity to Mediate and the Human Right to Self Determination: The Mediator’s Responsibility!

2015 ◽  
Vol 2 (1) ◽  
pp. 211-222
Keyword(s):  
Decision Making ◽  
Human Rights ◽  
Self Determination ◽  
Human Right ◽  
Decision Making Capacity ◽  
Guiding Principles

The purpose of this paper is to examine capacity in a mediation context including the level of responsibility a mediator has for assessing the capacity of participants; when that assessment should be made; and whether or not there are any guiding principles available to assist mediators in making the assessment. This is carried out, by reference to the available literature, under the following headings: the human rights origins of self-determination; capacity in a mediation context; the internationally recognised approaches to capacity; the best approach to capacity for mediators; and the obligations which will be imposed on mediators working in Ireland in view of the imminent Assisted Decision Making (Capacity) Bill 2013. The paper additionally looks at the skills necessary to assess capacity in mediation and asks if mediators’ training adequately provides them, and concludes that the responsibility to assess capacity to mediate rests solely with the mediator.

scholarly journals The use of community treatment orders in competent patients is not justified

2017 ◽  
Vol 210 (5) ◽  
pp. 311-312 ◽  
Author(s):  
Giles Newton-Howes ◽  
Christopher James Ryan
Keyword(s):  
Decision Making ◽  
Human Rights ◽  
Empirical Evidence ◽  
Community Treatment ◽  
Necessary Condition ◽  
Community Treatment Orders ◽  
Decision Making Capacity

SummaryEmpirical evidence for the effectiveness of community treatment orders (CTOs) is at best mixed. We examine CTOs through the prism of human rights and discrimination, bearing the evidence in mind, and argue that a necessary condition for their use is that a person lacks decision-making capacity.

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