live lesson PMA

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Beauchamp and
Childress (2001) Identify Autonomy of one of the 4 main principles of Ethics in
Health care stating Autonomy is the right of a competent adult to make
decisions about their treatment including the right to refuse treatment. Within
the Mental Health Act the principle of Autonomy has been raised. Doyal and
Sheather (2005) argue that autonomy is treated differently within mental health
compared to patients experiencing physical health problems. Within Part IV of
the Act treatment for mental illness can be given even when an adult with
capacity is not consenting. Where as in physical health conditions refusal from
a competent adult would be accepted.

Within the Act,
there needs to be significant risks to the patient or others for treatment of
symptoms of mental illness to go ahead without the consent of a competent
patient. The power for such treatment within the Act is there for the
protection of the patient and others. For example if patient A has been taking
his depot medication as prescribed. His mental state is stable and he would be
deemed to have capacity to consent to treatment or not. He states that he no
longer wishes to take the medication. If this was a patient being treated for a
physical problem, deemed to have capacity then it would be their choice to stop
the medication. However patient A has a significant history of violence when he
stops his medication, the RC can justify that the risks he poses are so
significant that treatment must continue In the interest of the safety of
others.

"Times New Roman";mso-ansi-language:EN-GB;mso-fareast-language:EN-GB;
mso-bidi-language:AR-SA">There is also concerns regarding coercion with regards
to informal patients and their treatment. There have been studies exploring
this further which have identified that patients feel threatened to take
treatment with statements implying that if they do not accept treatment then
they would be detained under the Act. Barker (2011) argues that this is just
staff fulfilling their requirement to give the patient relevant information to
decide if they want to take the medication or not however Sheehan and Burns,
(2015) state that it is often said implying that detention under the act is a
definite should they not take the medication when it may not be, this would be
deemed as coercion. For a decision to be truly autonomous it needs to be free
from coercion, manipulation and persuasion (Beauchamp and Childress, 2001). Barker
(2011) also feels that the mental health act does respect autonomy even for
patients who are detained under the Act. He argues that just because someone is
detained under the Act that it does not mean their views on their treatment
will not be respected. Of course this may just be that the treatment