Legal Frameworks
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England and Wales | Scotland | Northern Ireland | ||
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Legal rights: patients rights to refuse treatment | Powers to permit a clinician to treat despite refusal | Mental Health Act 1983 Section 63 – Treatment not requiring consent | Mental Health (Care and Treatment) (Scotland) Act 2003 Section 243 – Urgent medical treatment | |
Legal rights: advanced decisions | When patients have made a directive to refuse treatment | Mental Capacity Act 2005 | Mental Incapacity Act (Scotland) 2000 | |
Consent: informed | Informed consent is a process for getting permission before conducting a healthcare intervention on a person | Mental Health Act 1983 Section 63 – Treatment not requiring consent | Mental Health (Care and Treatment) (Scotland) Act 2003 Section 243 – Urgent medical treatment | Mental Health (Northern Ireland) Order 1986. |
Consent: express | Express consent is permission for something that is given specifically, either verbally or in writing. | As above | As above | |
Consent: implied | Implied consent is consent which is not expressly granted by a person, but rather implicitly granted by a person's actions and the facts and circumstances of a particular situation (or in some cases, by a person's silence or inaction). | As above | As above | |
Consent: presumed | The assumption that a particular action would have been approved by a person or party if permission had been sought. | As above | As above | |
Consent: patients who are unable to consent | Patients who are unable to consent including in life threatening situations and in patients with a recognised mental disorder who are at risk to themselves or others | As above | As above | |
Capacity | Legal frameworks for those who lack capacity | Mental Capacity Act (2005) of England and Wales detail appropriate legislation and safeguards | The Adults with Incapacity (Scotland) Act 2000 | A draft Mental Capacity bill is under parliamentary review in Northern Ireland. |
Confidentiality |
Professional Legal Data protection |
Guidance |
Guidance |
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Documentation |
National
and local processes Professional Legal |
Guidance |
Guidance |
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Detention | In hospital: temporary hold for an assessment to be arranged | Mental Health Act 1983 Sections
5(2) and 5(4) |
Sections 36 – Emergency detention and 44 – Short term detention of the
Mental Health (Care and Treatment) (Scotland) Act 2003 |
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Detention | In private premises: Search for and remove a patient | Mental Health Act 1983 Section 135 |
Sections 36 – Emergency detention 11.2.4 If the patient has been seen that day by any fully registered medical practitioner, e.g. the ward Doctor, then the option exists for that doctor to issue an Emergency Detention Certificate. They should then inform the appropriate duty AMP and the police, asking the police to consider the patient a missing person and to return them to hospital using the powers of the Emergency Detention Certificate. It should be noted that police have no power under this certificate to remove a person from a private place. If the person is found in a private place, an MHO would require to obtain a S.292 warrant | |
Detention |
In
public places: Removal of mentally disordered persons without a warrant |
Mental Health Act 1983 Section 136 |