The Moral Implication of Forcible Treatment of Individuals with Mental Disorder - Report Example

Human Rights and Mental Health: The Moral Implication of Forcible Treatment of Individuals with Mental Disorder of Professor Date of Submission Are human rights infringed in treatments for mental health? The relationship between human rights and mental health must be viewed in a historical perspective. Both concepts are somewhat contemporary that could be viewed as emerging from ideas during the ancient period. Mental health involves an array of relations and meanings that have went through major transformations over time. At present its meaning is universal, with ‘mental health’ denoting an expected norm of psychological health, and ‘mental disorder’ frequently supplanted by the debatably less stigmatizing or defaming association with ‘mental health problems’ (Saks, 2010). Recently the limits of the notion of mental health have broadened significantly hence the World Health Organisation (WHO) identifies mental health as (Dudley et al., 2012, 71): … a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. The repercussions of this comprehensive definition are substantial and suggest that the attainment of mental health can merely be achieved through the coordinated and collaborative efforts of a broad array of organisations working far beyond what are usually seen as services for individuals having mental disorders (Saks, 2010). Mental health legislation is needed for safeguarding the rights of mentally ill individuals. They experience discrimination and stigma in all cultures, and this heightens the possibility that their human rights will be infringed. Mental health legislation can develop legal guidelines for dealing with important issues like the integration of individuals with mental illnesses into the mainstream society, the delivery of premium care, the expansion of access to mental health care, the promotion and safeguarding of rights in other vital sectors like employment, education, and housing (Dudley et al., 2012). In addition, legislation can fulfil a vital function in preventing mental illnesses and cultivating mental wellbeing. Mental health legislation, especially those concerning human rights, is not only confined to treatment and care. Likewise, professional ethics are an important component of contemporary mental health practice and the ideals of autonomy, self-reliance, participation, and respect today traverse professional divisions. Mental Patient’s Right to Treatment in the UK Individuals who have mental problems can consult healthcare providers on their own free will, which is what takes place in most cases where individuals give consent to be treated. They can leave the hospital anytime they want, although physicians do not recommend it. As stated in the 1983 Mental Health Act, an individual can be hospitalised if s/he satisfies the following conditions (Barclay, 2011, 55): She’s suffering from a mental illness of a nature or degree that warrants detention in hospital; The detention is in the interests of the health and safety of that person or for the protection of others. Individuals who decline medication or treatment can be detained forcibly—or ‘sectioned’—as stated in the Mental Health Act. A social worker or closest relative of the mental health patient can request for the ‘sectioning’ of the patient (Barclay, 2011, 55). A social worker performs an evaluation of the patient, which two physicians have to approve. Every healthcare provider taking part in the procedure has to be endorsed by the Mental Health Act. The duration of hospitalisation and treatment rely on the kind of disorder. The Mental Health Act specifies conditions within which patients can be medicated or treated without their approval or consent and when the assessment of a second physician is needed (Saks, 2010). The Convention specifies that states have obligations to make sure that medical treatment is administered in accordance to Article 3. Similarly, the Human Rights Act (HRA) relates to legality of medical treatment in the UK (Barclay, 2011). Article 3 stipulates that states have positive obligations to make sure that the suffering that comes from disorder is not exacerbated by procedures administered with involve state duty. State obligation can be exercised in severe circumstances, situations concerning vulnerable individuals or where the power of the state over legal force is involved, like forcible treatment (Saks, 2010). Furthermore, medical treatment is predisposed to involve Article 8—respect for personal life. It should be considered that while an intervention with, for instance, a patient’s personal life can be defended under the conditions of Article 8(2), medicating a person in a debasing or inhuman manner which goes beyond the limit of severity will infringe Article 3 regardless of any assumed reasoning (Leino-Kilpi, 2000). Apparently, a competent patient can decline treatment even contrary to his/her recognised best interests. The self-determination of the patient is prevailing even though, it might seem, the patient is placed at a debasing situation. Decisions regarding incompetent patients are derived from an evaluation of the best interests of the patient (Barclay, 2011). Forcible treatment is defined as ‘treatment imposed, against his or her will, on a patient who is competent enough to give consent for medical treatment’ (Leino-Kilpi, 2000, 39). Evidently, this involves the power of the state over legal force. For example, in England and Wales forcible treatment is allowed under the 1983 Mental Health Act where the medication is for the mental state of the patient (Barclay, 2011). Ethical Analysis of Forcible Treatment Forcible treatment of individuals with mental disorder can be analysed within the context of situation ethics and utilitarianism. Situation ethics argues that the principle of right and wrong is dependent on the situation. Universal moral rights or laws are non-existent; every case is unique and calls for a unique intervention or response. It argues that ethical choices must conform to flexible rules instead of absolute ones, and be dealt with individually or separately (Meehl, 1991). Hence an individual who abides by situation ethics deals with ethical issues with some universal moral codes instead of an inflexible group of ethical rules and is willing to abandon those codes if it will result in the greater good. A person who is diagnosed of a mental disorder is, almost automatically, requires treatment (Meehl, 1991; Saks, 2010). And, if a person poses danger to him/herself or other people, then apparently s/he requires custody. But this principle is problematic within the context of situation ethics. The issue is, apparently, embedded with the term ‘need’. For instance, if it is described rigidly as ‘cannot live without’, thus an actual restriction on forcible commitment is formed (Roberts & Dyer, 2007). Nevertheless, generally, it is connected to the term ‘required,’ and the sole limitation on loss of self-determination is the opinion of the expert witness. For situation ethics, it is very hard to recognise the justifications that underlie custody of individuals with mental disorder. Three appear to be overriding (Meehl, 1991, 399): (1) It is thought desirable to restrain those people who may be dangerous; (2) It is thought desirable to banish those who are a nuisance to others; (3) It is thought humanitarian to attempt to restore to normality and productivity those who are not now normal and productive. All of these justifications are socially valid, but are problematic for situational ethicists. A comparable ethical perspective to situational ethics is utilitarianism. Utilitarianism argues that the appropriate or correct solution or response maximises utility, generally described as alleviating suffering and maximising pleasure or happiness. It is a somewhat straightforward ethical perspective to use. In order to identify whether an action is ethical one simply have to assess the positive and negative outcomes that will arise from a specific action. If the positive offsets the negative, then the action is ethical (Roberts & Dyer, 2007). Utilitarianism supports differential treatment, just like situational ethics. People show their trust in personal responsibility by declining to detain other than inability to make a competent or responsible choice. Hence, society does not detain a group, most of whom will take part in criminal activities, until those offenders have shown their irresponsibility and incompetence (Meehl, 1991). The mentally ill, based on utilitarian principles, could be seen progressively not backwardly because they see responsibility as a misleading idea. In view of utilitarianism, one way of solving this is to believe that mental disorder and criminal responsibility are not identical, and that if detention is to be defended based on lack of responsibility, only people with mental disorder who will perhaps, as a matter of calculation, perpetrate a criminal act for which they are not accountable for must be perpetrated (Dudley et al., 2012). A utilitarian course of action is to determine whether predisposition to criminal punishment is rationally associated with any social utility. If it is for the greater good to detain and treat individuals with mental disorder, utilitarian ethicists will agree with forcible treatment. Conclusion Forcible treatment of individuals with mental illness should be given much consideration and thorough caution. The concepts of self-determination and right to private life should be thoroughly evaluated against the greater good. Situational and utilitarian ethicists have a valid argument about forcible treatment—that is, it should be in lieu of the greater good. However, healthcare professionals must collaborate and coordinate with one another to come up with the most appropriate solution and course of action in case a mental health patient, or his/her family, declines treatment. Human rights violations happen when there is a reckless, thoughtless decision-making process. All that is involved in the process must be mindful of their responsibilities and knowledgeable of the various ethical or moral limitations of their preferred response or course of action. References Barclay, L (2011) UK Law and Your Rights for Dummies. UK: John Wiley & Sons. Dudley, M et al (2012) Mental Health and Human Rights: Vision, Praxis, and Courage. Oxford, UK: Oxford University Press. Leino-Kilpi, H (2000) Patient’s Autonomy, Privacy and Informed Consent. UK: IOS Press. Meehl, P (1991) Selected Philosophical and Methodological Papers. Minnesota: University of Minnesota Press. Roberts, L & Dyer, A (2007) Concise Guide to Ethics in Mental Health Care. New York: American Psychiatric Publication. Saks, E (2010) Refusing Care: Forced Treatment and the Rights of the Mentally Ill. UK: University of Chicago Press. Read More