Citation

Given K. NZMSJ 2014; (18/19): 26-28.

Copyright

(Copyright © 2014, New Zealand Medical Student Journal Organising Committee)

DOI

unavailable

PMID

unavailable

Abstract

Three principles form the basis on which every doctor-patient relationship should ideally be built- beneficence, non-maleficence, autonomy. In New Zealand, the third guiding principle, autonomy, is fraught with tension when considered alongside the legislation laid out in the Mental Health (Compulsory Assessment and Treatment) Act 1992 ("the Act"). There are a raft of reasons which can explain why the Act should be used to enforce treatment upon a patient. These include a patient's lack of competency to make decisions, the potential for societal harm, the maintenance of patients' rights, and the recent changes to the Privacy Act 1993,which is used in conjunction with the Act. However, there are several flaws with these arguments and, therefore, reasons against using the Act to impose treatment. These include some ambiguity regarding the definitions provided in section 2 of the Act, the lack of the maintenance of the fundamental right to refuse medical treatment, the potential for patients to experience harm as result of enforced treatment, and lastly, systemic issues regarding compliance to the Act.When these reasons, both for and against the use of the Act, are juxtaposed, it becomes clear that the Act should be imposed, but only when very specific criteria are met....

In summary, although there are some issues that arise from the Act and corresponding case law, it is clear these are overridden by the underlying purpose of the Act. Without this Act in place, it is likely that many patients would suffer unnecessarily at their own hands and that family members, friends, and colleagues of patients would be affected negatively. In addition, although there are allowances for some subjectivity, the Act provides fairly strict guiding criteria to allow consultant psychiatrists to make informed, reasonable, and objective decisions. With further consideration of the flaws raised above, it may be possible for judges and Parliamentarians to make decisions in the courts, or minor changes to Statute, which would provide an improved legislative structure for all stakeholders involved in the implementation of this Act.

Language: en