The MacArthur Treatment Competence Study. I: Mental illness and competence to consent to treatment.

1995 ◽  
Vol 19 (2) ◽  
pp. 105-126 ◽  
Author(s):  
Paul S. Appelbaum ◽  
Thomas Grisso
Keyword(s):  
Mental Illness ◽  
Consent To Treatment ◽  
Treatment Competence

The MacArthur Treatment Competence Study. II: Measures of abilities related to competence to consent to treatment.

1995 ◽  
Vol 19 (2) ◽  
pp. 127-148 ◽  
Author(s):  
Thomas Grisso ◽  
Paul S. Appelbaum ◽  
Edward P. Mulvey ◽  
Kenneth Fletcher
Keyword(s):  
Consent To Treatment ◽  
Treatment Competence

scholarly journals An Irish perspective on patients who lack the capacity to consent to treatment

1999 ◽  
Vol 23 (9) ◽  
pp. 522-524 ◽  
Author(s):  
John Hillery ◽  
David Tomkin ◽  
Adam McAuley
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Learning Disability ◽  
Dual Diagnosis ◽  
Legal System ◽  
Health Care Professionals ◽  
Service Provision ◽  
Consent To Treatment ◽  
Health Trust

Health care professionals in Ireland are concerned about the effect of L v. Bournewood Community and Mental Health Trust ex parte L (1998). Despite Ireland's distinct legal system and different service provision, this case has highlighted existing concerns about the treatment of patients with a dual diagnosis of learning disability and mental illness.

scholarly journals End-of-Life Decision-Making Capacity in Older People With Serious Mental Illness

2021 ◽  
Vol 12 ◽  
Author(s):  
Carla Kotzé ◽  
Johannes Lodewikus Roos ◽  
René Ehlers
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Older People ◽  
End Of Life ◽  
Serious Mental Illness ◽  
Decision Making Capacity ◽  
Consent To Treatment ◽  
Advance Care ◽  
End Of Life Decision ◽  
Life Decision

Background: The study's main aim was to assess the end-of-life decision-making capacity and health-related values of older people with serious mental illness.Methods: A cross-sectional, observational study, was done at Weskoppies Psychiatric Hospital, Gauteng Province, South Africa that included 100 adults older than 60 years of age and diagnosed with serious mental illness. The Mini-Cog and a semi-structured clinical assessment of end-of-life decision-making capacity was done before a standardized interview, Assessment of Capacity to Consent to Treatment, was administered. This standardized instrument uses a hypothetical vignette to assess decision-making capacity and explores healthcare-related values.Results: The Assessment of Capacity to Consent to Treatment scores correlated (p < 0.001) with the outcomes of the semi-structured decision-making capacity evaluation. Significant correlations with impaired decision-making capacity included: lower scores on the Mini-Cog (p < 0.001); a duration of serious mental illness of 30–39 years (p = 0025); having a diagnosis of schizophrenia spectrum disorders (p = 0.0007); and being admitted involuntarily (p < 0.0001). A main finding was that 65% of participants had decision-making capacity for end-of-life decisions, were able to express their values and engage in advance care discussions.Discussion and Conclusion: Healthcare providers have a duty to initiate advance care discussions, optimize decision-making capacity, and protect autonomous decision-making. Many older patients with serious mental illness can engage in end-of-life discussions and can make autonomous decisions about preferred end-of-life care. Chronological age or diagnostic categories should never be used as reasons for discrimination, and older people with serious mental illness should receive end-of-life care in keeping with their preferences and values.

The Mental Health Act 1983

2017 ◽  
Vol 10 (11) ◽  
pp. 638-643
Author(s):  
Jonathan Mills ◽  
Jaspreet Phull
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Problems ◽  
Legal Framework ◽  
Health Problems ◽  
Practical Application ◽  
England And Wales ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
Insight Into

Mental health problems constitute a significant demand on the caseload of GPs. Although most patients can be managed with joint understanding and agreement as to treatment, GPs will encounter patients deemed to have mental illness of such severity that the patients’ ability to consent to treatment, admission or ongoing management in the community is brought into question. Patients may refuse necessary treatment, or lack insight into their condition and the necessary treatment. The patient may not accept that they are unwell. This can put great demands on caregivers and also requires knowledge of the legal framework necessary to ensure treatment of patients safely, legally and ethically. This article aims to outline the Mental Health Act 1983 as it applies in England and Wales, and to give advice on its practical application.

scholarly journals 214 - End-of-life decision-making capacity in older people with serious mental illness

2021 ◽  
Vol 33 (S1) ◽  
pp. 15-16
Author(s):  
Carla Kotzé ◽  
Louw Roos ◽  
René Ehlers
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Older People ◽  
End Of Life ◽  
Serious Mental Illness ◽  
End Of Life Care ◽  
Decision Making Capacity ◽  
Consent To Treatment ◽  
End Of Life Decision ◽  
Life Decision

ABSTRACTObjectives:The study’s main aim was to assess the end-of-life decision-making capacity and health-related values of older people with serious mental illness.Design, Setting, and Participants:This was a cross-sectional, observational study, done at Weskoppies Psychiatric Hospital, Gauteng Province, South Africa that included 100 adults older than 60 years of age and diagnosed with serious mental illness.Measurements:Socio-demographic, diagnostic, and treatment data were collected before administration of the Mini- Cog and a semi-structured clinical assessment of end-of-life decision-making capacity. Finally, the standardized interview, Assessment of Capacity to Consent to Treatment, was administered. This standardised instrument uses a hypothetical vignette to assess decision-making capacity and explores healthcare-related values.Results:According to the semi-structured decision-making capacity assessment, 65% of participants had decision-making capacity for end-of-life decisions. The Assessment of Capacity to Consent to Treatment scores were significant (p<0.001) when compared to decision-making capacity. Significant correlations with impaired decision-making capacity included: lower scores on the Mini-Cog (p<0.001); a duration of serious mental illness of 30-39 years (p=0025); having a diagnosis of schizophrenia spectrum disorders (p=0.0007); and being admitted involuntarily (p<0.0001).Conclusions:Two thirds of older people with serious mental illness had decision-making capacity and were able to engage in end-of-life care discussions. Healthcare providers have a duty to initiate advance care discussions, optimize decision-making capacity, and protect autonomous decision-making. Chronological age or diagnostic categories should never be used as reasons for discrimination, and older people with serious mental illness should receive end-of-life care in keeping with their preferences and values.

scholarly journals The emergency treatment of overdose: a problem of consent to treatment

1995 ◽  
Vol 19 (1) ◽  
pp. 7-9
Author(s):  
Tim Hardie ◽  
Kamaldeep Bhui ◽  
Phillip Brown
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Disorder ◽  
Medical Treatment ◽  
Emergency Treatment ◽  
Civil Law ◽  
Consent To Treatment ◽  
Definition Of ◽  
Consent To Medical Treatment ◽  
Law Commission

We surveyed 119 psychiatrists to see how they would act with a patient who has taken a potentially lethal overdose, has no mental illness, and is refusing treatment. There was substantial disagreement. There may be a risk of action under civil law whether the psychiatrist decides to treat the patient without his or her consent or not. The Law Commission are examining whether mental disorder, as defined in the Mental Health Act 1983, should be used as a test of Incapacity to give consent to medical treatment. Such legislation would help doctors but may encourage a wide interpretation of the definition of mental disorder.

Ireland's Mental Health Act 2001: where are we now?

2009 ◽  
Vol 33 (5) ◽  
pp. 161-164 ◽  
Author(s):  
Áine Ni Mhaoláin ◽  
Brendan D. Kelly
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Human Rights ◽  
United Nations ◽  
International Standards ◽  
European Convention ◽  
Involuntary Admission ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
The Right

SummaryIreland's Mental Health Act 2001 was fully implemented in 2006 and aimed to bring Irish legislation more in line with international standards such as the European Convention on Human Rights and United Nations Principles for the Protection fo Persons with Mental Illness. the new legislation introduced several important reforms in relation to involuntary admission, independent reviews of involuntary detention, consent to treatment, and treatment of children and adolescents. Although the Mental Health Act 2001 focuses clearly on protecting the right to liberty, it also presents significant challenges in terms of service delivery and resources within Irish mental health services.

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

A Tribute to the Late William J. Curran

1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
United Nations ◽  
Mental Health Care ◽  
Harvard University ◽  
Legal Medicine ◽  
General Assembly ◽  
International Institute ◽  
University Professor

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.

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