Mental Health Legislation

Question 1

What are the main pieces of civil health law?

Answer 1

Mental Health (Care and Treatment) (Scotland) Act 2003

Adults with Incapacity (Scotland) Act 2000

Question 2

What is the definition of compulsory?

Answer 2

1. Required by law or a rule; obligatory
2. Involving or exercising compulsion;coercive

Question 3

Why would you do involuntary treatment for mental illness?

Answer 3

Severely unwell, lost touch with reality (psychotic)

Risk to self or others

Question 4

What are general criticisms of involuntary treatment?

Answer 4

Seen as ill-liberal

May be poorly compatible with international human rights norms

Unnecessary for most patients

Counterproductive for some patients

Practical problems in administering treatments

Question 5

What are ethical criticisms of involuntary treatment?

Answer 5

Ethical principles:

• Non-maleficence
• Autonomy (liberty)
• Paternalism (hard - ignores patient’s views)
• Non-discrimination (physical vs mental illness e.g. diabetes)

Question 6

Definition of a mental disorder

Answer 6

Any mental illness, personality disorder or learning disability however caused or manifested.

Question 7

What are features of Adults With Incapacity Act in Scotland?

Answer 7

Allows legally valid decisions to be made for those who lack mental capacity

Transfer of decision-making rights from impaired (disabled) individual to another

Typical outcome of AWIA > Guardianship; Some shortcuts e.g. for doctors (“section 47”), social workers (housing)

Question 8

What are the criteria for incapacity in AWIA?

Answer 8

“Incapable” means incapable of:

a) Acting or
b) Making decisions or
c) Communicating diseases or
d) Understanding decisions or
e) Retaining the memory of decisions; only needs to have significant impairment in one area to have capacity

Question 9

What does the ability to make decisions about finances, welfare and medical treatment require attributes to?

Answer 9

Reason and deliberate

Hold appropriate values and goals

Appreciate one’s circumstances

Understand information one is given

Communicate a choice

Question 10

What Is Legal Capacity?

Answer 10

“The ability to hold rights and duties (legal standing) and to exercise these rights and duties (legal agency)”

Question 11

Ethics of capacity law

Answer 11

Autonomy:

• In theory, promotes (principles)
• In practice, may diminish (mechanisms)

Non-discrimination:

• Allows legally-valid decisions for disabled people
• Transfers powers away from disabled people