The legal and ethical framework for psychiatry

Abstract 

The compulsory detention and treatment of patients is one of the key ethical issues facing psychiatry. It involves clinicians overriding the apparent autonomy of their patients. This can be justified by arguments that the patient’s autonomy is reduced, that the benefits of detention outweigh the cost, or that the apparent autonomy of the patient is not their real autonomy. Unfortunately, none of these arguments is without problems. The legal basis for detention and treatment is equally complex. Two acts – the Mental Health Act and the Mental Capacity Act – apply to patients with mental illness. In the Mental Health Act, the patient with a mental disorder can be detained and treated in the interests of their own health or safety, or for the prevention of harm to others. Under the Mental Capacity Act, the patient who lacks decision-making capacity may have decisions made in their best interests. Whether ethics and law in psychiatry can be simplified is a fascinating question for the future.

Keywords: autonomy, ethics, law, Mental Capacity Act, Mental Health Act, psychiatry