Patients with mental disorders will be given the right to consent to – or refuse – medical treatment under a radical and overdue overhaul of Bermuda’s mental health laws.
The raft of proposed changes also include establishing a mental health regulatory authourity, community treatment orders and a code of practice.
Health Minister Kim Wilson announced the proposals at a press conference on Monday and asked for public feedback by the end of the month.
The current law, the Mental Health Act, 1968, is silent on the issue of consent, containing no protections for patients who refuse treatment or guidelines governing situations where a patient does not have the capacity to consent.
This perhaps is one of the more important amendments proposed in this consultation paper, states the online consultation document.
Without clear guidance with regard to consent to treatment, a patient, the mental health service providers who treat them and possibly others may be at risk of harm should there be undue delay in treatment caused by a patient objecting and seeking a judicial review of the decision to administer treatment against his/her will.
Under the new regime, psychosurgery would require the patient’s consent, a second opinion and that the treatment is necessary.
A patient’s consent would also be required if three months has elapsed since first treatment and for electroconvulsive therapy would be off limits unless the patient has consented. In all cases an independent medical practitioner must certify that the patient has the capacity to give consent.
Exceptions would be made for urgent and emergency situations and where the patient’s life is at stake.
And an independent practitioner’s certification would be required when a patient lacks capacity to consent.
The Mental Capacity provisions recommended will define a person who lacks capacity, outline a framework for assessing whether a person is unable to make a decision and therefore lacks capacity, and ensure decisions taken for those who lack capacity are done so in that person’s best interests,” said Ms Wilson.
Other proposed changes include
- Establishment of an independent mental health regulatory authority charged with safeguarding patients’ rights. The authority will received reports on patients whose treatment require consent or who lack capacity to consent to treatement
- removing a requirement that a relative has to sign an application to admit a person to the hospital. Admissions and discharges will require consultation with the nearest relative who will still have the power to block admission.
- Community treatment orders. Patients allowed to remain in the community under certain restrictions, but can be recalled if they do not comply.
At Monday’s press conference, Ms Wilson said that the policy and legislative reform will take place in two phases with the current phase addressing urgent issues.
The Mental Health Act Consultation Paper can be found at www.gov.bm/health-public-consultations. For any questions or clarifications, the public may email firstname.lastname@example.org. February 28 is the deadline for feedback.
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