In whose best interests? An examination of the ethics of the UK government's White Paper ‘Reforming the Mental Health Act’
- 8 August 2002
- journal article
- research article
- Published by Wiley in Journal of Psychiatric and Mental Health Nursing
- Vol. 9 (4), 399-404
- https://doi.org/10.1046/j.1365-2850.2002.00513.x
Abstract
Throughout history the legislative framework for the treatment of the mentally ill has reflected societies’ attitudes, and the proposals in the United Kingdom (UK) govern‐ment's White Paper ‘Reforming the Mental Health Act’ are no exception. This paper examines some of the fundamental ethical issues invoked by the proposals, particularly the concept of paternalism and use of risk assessment in determining ‘best interests’. The issue of power in relation to the mentally ill is also examined, alongside the impact of the change on nurses’ ethical decision making. As will be seen, the proposed Act will require high standards of professional practice to ensure the ethical application of care, particularly in the case of individuals diagnosed as suffering from ‘dangerous and severe personality disorders’. Nurses need to ensure that the interventions used are of the highest quality and are indeed in the patient's ‘best interests’. If they are not, then again nurses need to be very clear as to why the profession should be involved at all. Nurses should demonstrate vigilance and high professional standards to ensure they are maintaining rigorous safeguards to promote the public interest. Although relating specifically to UK legislation the underlying ethical dilemmas posed by this proposed legislation are relevant to all mental health nurses, as they challenge fundamental assumptions regarding the role of nurses in supporting mental health legislation that may have a social, rather than therapeutic, function.Keywords
This publication has 11 references indexed in Scilit:
- Risk management in UK mental health services: an overvalued idea?Psychiatric Bulletin, 2001
- Practical application of structured risk assessmentThe British Journal of Psychiatry, 2001
- Care of older people: Maintaining the dignity and autonomy of older people in the healthcare settingBMJ, 2001
- Violence risk prediction in practiceThe British Journal of Psychiatry, 2001
- Violence risk predictionThe British Journal of Psychiatry, 2000
- Role of risk assessment in reducing homicides by people with mental illnessThe British Journal of Psychiatry, 2000
- Dangerous people with severe personality disorderBMJ, 1999
- Who should take responsibility for antisocial personality disorder?BMJ, 1999
- Respecting the autonomy of cancer patients when talking with their families: qualitative analysis of semistructured interviews with patientsBMJ, 1996
- The Reorganization of the Medical ProfessionMedical Care Review, 1985