In mental health treatment, the doctrine of informed consent is vital for the welfare of the patient. In informed consent, a patient is required to give consent based on clear comprehension of all facts, implications and the consequences of the treatment (Neilson and Chaimowitz, 2015). In some places such as the UK, it is necessary for a medical practitioner to have informed consent from the patient before commencing any medical treatment. The principle of informed consent is based on respect for a person's dignity. An individual giving the informed consent is expected to be of a sound mind in possession of all relevant facts. People with impaired reasoning or judgment cannot give informed consent.
For a valid informed consent, there are three vital aspects that must be considered; disclosure, voluntariness, and capacity (Amer, 2013). The disclosure includes the doctor's supply of all relevant information to the patient and ensuring the patients totally comprehends the information. Capacity means that the person making the decision has the ability to understand the information that has been shared and can consider the information before making a decision. Voluntariness ensures that the patients make their own decisions without pressure.
Relevance to Individuals Suffering from Mental Health Issues
The key issue relating informed consent and mental health is the foreseeable aspect that a mentally ill person will be unable to comprehend any explanation given and will be unable to make a knowing and sound decision. it is vital that the person who is given the task of making the informed decision has the capability of understanding relevant information utilizing it in decision-making which is not guaranteed to mentally ill individuals.
In 1990, a patient brought a case to the US Supreme Court against hospital physicians, doctors and other staff members of two mental institutions for violation of his rights. Darrell Burch, who had been found wandering while injured, disillusioned and psychotic, was taken to a private mental facility by a Good Samaritan (Isaac & Brakel, 1992). The hospital diagnosed him with acute schizophrenia and transferred him to Florida State Hospital for further treatment. In both institutions, the patient was registered as a voluntary patient as he had signed voluntary admission forms as well as consent-to-treatment forms.
After release from the mental institution, Burch registered a complaint that he did not remember signing the voluntary admission and consent forms. Utilizing section 1983, he filled a case federal courts claiming that his rights were violated as he received treatment as a voluntary patient while he was not in a state to make decisions (Isaac & Brakel, 1992). The case reached the Supreme Court and in 1990, the court made a decision.
In a split 5-4 decision, the Supreme Court ruled that Burch had a right to bring the case to the federal courts. According to the judges, Florida law clearly stated that an informed consent is necessary before treating a mentally-ill patient. However, he also stated that no law dictated that physicians should determine the capability of a patient to make decisions. The judge ruled that states have to ensure that patients have the competence required to make sure that the patient has the capability to make informed decisions and could be found liable if they failed to perform the task.
The ruling enabled mental institutions to put up policies to ensure that admissions were voluntary and the hospital assessed the ability of the patient to consent. This has changed the status of patients from 1960's where the majority of the patients were involuntary to current days where more than 73% of the annual admissions is voluntary (Amer, 2013). The American Psychiatric came up with an easy criterion for admission in which a patient has to understand that he is in the ward and by verbal, audio or behavioral action the patient can consent to admission.
The informed consent in mental health institutions has led to better treatment for patients. The ability of patients to choose the medical intervention ensures that they have a high probability of cooperation with the physicians. It is also important to note that the policy provides for situations such as emergency and necessities where the doctrine of informed consent can be overrun (Amer, 2013). This enables emergency interventions to be taken in cases of grave danger or when patients life is at risk without the need for consent.
Informed consent is vital for the success of the treatment. We can equate the consent as an agreement between a physician and a patient where the patient volunteers to undergo some certain medical procedures while the doctor agrees to deal with the patient with expertise within the agreed boundaries (Amer, 2013). It is important for the doctor to work ethically and with high levels of integrity. It is also important for the doctor to share information with a patient in a manner that the patient totally understands and to ensure that the patient understands the consequences of their choices. A beneficial relationship between clinician and patience utilizes trust, mutuality, and collaboration in the decision-making process.
Amer, A. (2013). Informed consent in adult psychiatry. Oman Medical Journal, 28(4), 228-231. http://dx.doi.org/10.5001/omj.2013.67
Isaac, R., & Brakel, S. (1992). Subverting good intentions: a brief history of mental health law reform. Cornell Journal Of Law And Public Policy, 2(1).
Neilson, G., & Chaimowitz, G. (2015). Informed consent to treatment in psychiatry. Journal Of Psychiatry, 60(4), 1-11.
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