Ethics and Section 58 of the Mental Health Act (1983)

Extract

Section 58 is in the part (Part IV) of the Act which is largely concerned with consent to treatment by patients detained on Sections 2, 3, or 37 of the Mental Health Act (1983). It applies to drug treatment if three months or more have elapsed since drugs were first given during the period of detention. It also applies to ECT at any time during the period of detention. Where a patient consents to treatment which comes under Section 58, and which the responsible medical officer (RMO) has proposed and explained to the patient, the RMO is required to certify in writing, on Form 38, that the patient is capable of understanding the nature, purpose and likely effect of the treatment and that the patient has consented (DOH, 1987). The Code of Practice (DOH, 1990) advises that the RMO should indicate on the certificate the drugs proposed, by the classes described in the British National Formulary (BNF), indicating the dosages if they are above BNF advisory maximum limits. The method of administration should also be indicated. This paper will argue that Section 58 in its present form does not strengthen the patient's right to consent to treatment and that the form of words advised in the Code of Practice with respect to Form 38 is faulty in conception.