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Ethics and Section 58 of the Mental Health Act (1983)

Published online by Cambridge University Press:  02 January 2018

Femi Oyebode*
Affiliation:
Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham B15 2QZ
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Section 58 is in the part (Part IV) of the Act which is largely concerned with consent to treatment by patients detained on Sections 2, 3, or 37 of the Mental Health Act (1983). It applies to drug treatment if three months or more have elapsed since drugs were first given during the period of detention. It also applies to ECT at any time during the period of detention. Where a patient consents to treatment which comes under Section 58, and which the responsible medical officer (RMO) has proposed and explained to the patient, the RMO is required to certify in writing, on Form 38, that the patient is capable of understanding the nature, purpose and likely effect of the treatment and that the patient has consented (DOH, 1987). The Code of Practice (DOH, 1990) advises that the RMO should indicate on the certificate the drugs proposed, by the classes described in the British National Formulary (BNF), indicating the dosages if they are above BNF advisory maximum limits. The method of administration should also be indicated. This paper will argue that Section 58 in its present form does not strengthen the patient's right to consent to treatment and that the form of words advised in the Code of Practice with respect to Form 38 is faulty in conception.

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Forum
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists 1993

References

Beauchamp, T. L. & Childress, J. L. (1979) Principles of Biomedical Ethics, 2nd edition. Oxford University Press.Google Scholar
Department of Health (1990) Code Of Practice. London: HMSO.Google Scholar
Department of Health (1987) Mental Health Act 1983 Memorandum on Parts I to VI, VIII and X. London: HMSO.Google Scholar
Jones, R. (1988) Mental Health Act Manual, 2nd Edition. London: Sweet & Maxwell.Google Scholar
Meisel, A., Roth, L. H. & Lidz, C. W. (1977) Toward a model of the legal doctrine of informed consent. American Journal of Psychiatry, 134, 285289.Google Scholar
Roth, L. H., Meisel, A. & Lidz, C. W. (1977) Tests of competency to consent to treatment. American Journal of Psychiatry, 134, 279284.Google Scholar
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