I am working with South Australian law but am interested in international law. Who are the carers?. What support do they receive? Have used deontological and utilitarian ethics, where does ethic of care come in? How can the needs of the patient be balanced with the needs of carers, families and communities? Stereotyping of the patients and their needs is a problem.
Thanks for that Napoleon. I believe that we should individualise the care. Was wondering how other professionals do this as I have come across stereotyping from other professionals. Cheers. Kerre
First, there is the general medical imperative, Hippocratic in origin, to care for those in need. Because a patient's illness is psychiatric rather than physical does not lessen the charge. If the patient is an involuntary admission he or she may be either in a psychiatric facility or a penal institution. Either way, issues of the necessity of care are then centred on the institution's medical personnel as well as on patient and patient family concerns. The latter will depend on the nature of the incarceration and the local legal requirements attending to psychiatric patients. Those in most penal systems loose some rights to choice but retain full rights to care.
The thing to ask yourself is why think that necessities of care are any different for a psychiatric patient than one with other kinds of illness. And do remember most psychiatric disorders result from underlying physical causes, including chemical imbalances, etc.
Being "involuntary" also known as "being under the Act" is an intervention and a protective means available across the world for people who are severely affected by a mental illness. The principles are based on The United Nations Principles for the Protection of Rights of People with Mental Illness and for the Improvement of Mental Health Care 1991. The "carers" are defined in the Act-so that answers who is a carer. Most mental health services provide holistic care based on the systems theory and would provide services for both the "patient" and the "carer".
These are good, very helpful. Determining and defining the nature of care is a slippery slope.
Be aware that Article 14 of the United Nations Convention on Rights of Persons with Disabilities significantly challenges the concept of involuntary treatment. As adopted by UN General Assembly in 2006 it also derogates the Principles mentioned by Tawanda Machingura. As for current perspective of the monitoring committee (UN CRPD Committee) the involuntary treatment itself is deemed illegal in this part of international law and state parties are criticized and urged to change their respective legislations. However, the UN contradicts to other relevant parts of international law, especially Council of Europe and it remains to be seen how this issue will be regulated in future. That would surely change the aspects concerning care takers.
I am more concerned about the moral implications of not caring for our psychiatric patients, whether it is a family member or a community. We are lacking. There is no leadership...still flying a cultural flag of denial and fear toward those most in need.
Hi Kerre
In the UK involuntary patients are called 'formal patients' under the Mental Health Act and will be detained under a mental health section. Therefore, even though their relatives' views are taken in to accouint they are solely cared for by the mutlidiscipliniary team in the psychiatric facility. This team is lead by a consultant psychiatrist who is called a 'Responsible Clinician (RC)' under the Mental Health Act. This RC has the final say with all decisions about the care of patient. So the carers are always the staff and once the patient has left the psychiatric facility they may be cared for in the community by a Community Mental Health Team,even though they may also be cared for by relatives. In other words the care of a patient under section is always the responsibility of their local mental health services. Does this help? Do you need anything clarified? Tara.
Depending on the quality of the care a person receives, he or she may transform from being 'involuntary' to being 'voluntary'. It doesn't always happen, but many times it does, so it is always worth trying to try one's best to do whatever evidence has shown to be most effective for the majority.
Thank you everyone, these comments give a lot a guidance and "food for thought".
Kerre
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