Being subject to Section three of the Mental Health Act 1983 removes some rights taken for granted by members of today's society. Patients subject to this Mental Health Act may find it difficult to exercise the right of autonomy, and furthermore face many ethical dilemmas whilst under a Mental Health Section. This paper aims to identify and reflect on such a situation witnessed by a second year mental health student whilst on placement at an intensive support psychiatric unit.It will analyze the legal and ethical dilemma, and relate theory to practice in the context of medical ethics. The principles of Autonomy, beneficence, and justice will be raised and a rational for these theories will be interpreted, based around the dilemma of treatment without consent.
[...] Whilst living in the comfort of the mental health act to force treatment where necessary, we should endeavor to gain an acceptance for treatment in an effort to promote therapeutic privilege. The relevant theories of ethics have been identified and discussed and the legal implications of the event explored. It is acknowledged that ethical dilemmas are a common in the field of Psychiatric nursing and involvement and exposure to similar events will support the desire for a strive for excellence by the author. [...]
[...] As ECT had been identified as a reasonable prognosis to her diagnosed condition, the justice principle would seek to ensure she the does receive treatment. The policy questions about justice in health care rationing can be seen in the work of Daniels,(1985) who has extended Rawls's (1971)clear theory of justice to apply to the health care system. Daniels advocates a general theory according to which the health care system should be designed so as to bring everyone as close as possible to a decent minimum level of health, which he refers to as "normal species functioning". [...]
[...] To have the privilege of autonomy in the health care setting, Schneider (1998) suggests that the patient must be able to present themselves in a manor that is competent to make an informed choice, further more Gillon, (1986) cited in Rumbold (1999), stated that they must have the capacity to think and act on the basis of such thought and freely and independently, without let or hindrance. This is supported by the written guidelines and codes to which the healthcare professional must subscribe, Nursing Midwifery Council code of ethics (2002). [...]
[...] Chally P (1998) Ethics in the Trenches: decision making in practice American Journal of Nursing 98(6) 17- Clare,A.(1976) Psychiatry in dissent.London:Tavistock Daniels,N(1985)Just Health Care.Cambridge:Cambridge University Press. Department of health and Welsh Office (1990)Code of practise.London.HMSO Edwards,S.D(1996)Nursing Ethics: A Principle based approach.Basingstoke:Macmillan Epstein,E.(1993)From irreverence to irrelevance.The growing disjuncture of treatment theories from social realities.Journal of systematic therapies.12,15-27 General medical council (2004) retrieved from www.gmc- uk.org/standards/default.htm on 2nd December 2004 Gillon R. (1994)Medical ethics: four principles plus attention to scope. BMJ 1994;309:184-. [...]
[...] It would be only too easy to adopt regimented procedures in heretic from the Victorian era of mental health nursing, and forcibly treat patients with medication or arguably, methods of extreme treatment programs. It is necessary at times to have to establish the ethical rights of the patient versus the paternalistic approach of the service providers when considering the best treatment required. It is equally important to establish the needs of the patient and establish the benefits of not treating against the loss of any further therapeutic privilege, if forced treatment is to be executed. [...]
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