Blackstone's Guide to the Mental Health Act 2007

摘要

There is one sharp distinction between psychiatry and all other forms of medical practice. In all the other branches of medicine, treatment is by consent. Although in modern psychiatric practice the bulk of treatment is by consent, there are still some people who are unable to give consent because of mental incapacity, and there are some people who are considered to be such a danger either to themselves or to others that they have to be treated without their consent. Until recently in England and Wales the care of the first group was governed by the Mental Capacity Act 2005 and the treatment of the second by the Mental Health Act 1983 (both of these, of course, consolidating and amending a huge body of legislation going back to some of the earliest recorded English laws). The new Mental Health Act 2007 has introduced further very substantial amendments to both of these acts. In particular it raised the difficult problem of coping with people whose mental state is such that they are a serious danger to themselves or others, but are not deemed to be treatable by current psychiatric methods. This is a very thorny topic. Detaining people because it is thought that they might commit crimes is a very serious threat to civil liberty, as also is compelling people to submit to treatment while remaining at large in the community - to say to someone "We will allow you to live in your own home on condition that you take these pills every day" could be the thin end of a nasty wedge.