Advance decisions and advance statements

2010 ◽  
pp. 197-204 ◽  
Author(s):  
Jane Lynch ◽  
Louise M Terry ◽  
Sue Battersby ◽  
Colum J Smith
Keyword(s):  
Advance Statements ◽  
Advance Decisions

Advance statements in adult mental health

2010 ◽  
Vol 16 (6) ◽  
pp. 448-455 ◽  
Author(s):  
Jelena Jankovic ◽  
Felicity Richards ◽  
Stefan Priebe
Keyword(s):  
Mental Health ◽  
Psychiatric Treatment ◽  
Mental Capacity ◽  
Treatment Preferences ◽  
Limited Evidence ◽  
Adult Mental Health ◽  
Satisfaction With Treatment ◽  
Barriers To Implementation ◽  
Advance Statements ◽  
Advance Decisions

SummaryThis article reviews the literature on advance statements, including current mental health law and guidance in England and Wales, ethical and practical advantages, disadvantages and barriers to implementation. The idea of planning psychiatric treatment for a time when mental capacity may be impaired is not new. Yet there has been a renewed interest following the introduction of the Mental Capacity Act's 2005 provision of legally binding advance decisions to refuse treatment. In addition to information on treatment refusals, advance statements provide information on treatment preferences and personal care instructions which, although not legally binding, should inform treatment decisions. Advance statements are not yet widely used, but existing limited evidence suggests that they could reduce coercion and improve service users' satisfaction with treatment.

Psychiatrists’ views on different types of advance statements in mental health care in Germany

2018 ◽  
Vol 64 (8) ◽  
pp. 737-744 ◽  
Author(s):  
Astrid Gieselmann ◽  
Alfred Simon ◽  
Jochen Vollmann ◽  
Bettina Schöne-Seifert
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Different Types ◽  
Advance Statements

scholarly journals Least restrictive alternative – advance statements and the new mental health legislation

2002 ◽  
Vol 26 (7) ◽  
pp. 246-247 ◽  
Author(s):  
J. M. Atkinson ◽  
H. C. Garner
Keyword(s):  
Mental Health ◽  
Home Office ◽  
Policy Makers ◽  
Department Of Health ◽  
Mental Health Legislation ◽  
Advance Statements ◽  
Restrictive Environment ◽  
The Patient’S View ◽  
Health Legislation ◽  
Least Restrictive Alternative

Proposals for new mental health legislation make the case for using the ‘least restrictive alternative’ (Scottish Executive, 2001) and the ‘least restrictive environment’ (Department of Health & Home Office, 2000) as guiding principles in deciding the management and treatment of the patient. This appears to be the case made for introducing compulsory treatment in the community. The patient living in the community, while maintained on medication, rather than the hospital would appear to be defined as on the ‘least restrictive alternative’. This, however, takes only a limited approach to what is ‘restrictive’, which should be interpreted more widely, including the patient's view as well as that of clinicians and policy makers. Thus, a patient may see it as less restrictive during an acute phase to be in hospital and not on medication, than in the community but on medication. It is likely, given our knowledge of patients' attitudes to medication (Eastwood & Pugh, 1997), that many patients will prefer to be on oral medication rather than depot, which they see as less restrictive.

4. Consent to Treatment

2018 ◽  
Author(s):  
Jonathan Herring
Keyword(s):  
Mental Capacity ◽  
Best Interests ◽  
Living Wills ◽  
Ethical Aspects ◽  
Capacity To Consent ◽  
Delicate Balance ◽  
Mental Capacity Act 2005 ◽  
Consent To Treatment ◽  
Advance Decisions ◽  
Mental Capacity Act

This chapter examines the legal and ethical aspects of treating a patient without consent. It considers the meaning of ‘consent’ and the position of patients who lack the capacity to consent. For children who lack capacity, consent involves a delicate balance between the rights of the children and those of their parents. For adults lacking capacity, the Mental Capacity Act 2005 has emphasized the ‘best interests’ test, but has largely left open the question of how a person’s best interests are to be ascertained. The chapter also considers what weight should be attached to advance decisions (sometimes called living wills).

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