new approaches to communication

econnection with self

holistic approach to patient care

The definition of 'medical treatment' 13. This is defined by s145(1) and (4): '145 - Interpretation (1) In this Act, unless the context otherwise requires- '"medical treatment" includes nursing, psychological intervention and specialist mental health habilitation, rehabilitation and care (but see also subsection (4) below); (4) Any reference in this Act to medical treatment, in relation to mental disorder, shall be construed as a reference to medical treatment the purpose of which is to alleviate, or prevent a worsening of, the disorder or one or more of its symptoms or manifestations.' 14. The basic definition is inclusive of what may constitute medical treatment ('includes'), not exhaustive. But para (4) provides that the test for medical treatment (whether as expressly defined in subs(1) or not) is its purpose. That is consistent with the basic distinction between containment and treatment. Treatment must be given for the purpose of alleviating or preventing the worsening of the patient's disorder, symptoms of manifestations. Treatment is not defined by reference to its likely effect. But, as a practical matter, that will have been taken into account by the clinical team in deciding whether the treatment could be given for a permitted purpose. There is no limit of time; the team may make that judgment in the short, medium or long term. 15. Those provisions only define 'medical treatment'. They do not define the circumstances in which medical treatment is either available or appropriate. It is possible that medical treatment may be available without being appropriate, appropriate without being available, both or neither.

personality disorder

found that the criteria for detention in s72 of the 1983 Act were made out, namely he was suffering from mental disorder (which it characterised as a psychopathic personality disorder), it was of a nature or degree which made it appropriate for him to be liable to be detained in a hospital for medical treatment, such treatment was necessary for the protection of others, and appropriate medical treatment was available, namely treatment which had the purpose of treating the disorder and which was appropriate for MD

The appropriate medical treatment test (ATT), included in the Mental Health Act (MHA) (1983, as amended 2007), aims to ensure that detention only occurs when treatment with the purpose of alleviating a mental disorder is available.

An important amendment was the abolition of the ‘treatability’ criterion of the 1983 MHA, whereby individuals with mental disorder could be detained only if the potential treatment was considered ‘likely to alleviate or prevent a deteroration of (the patients) condition’. The amended legislation (MHA 1983, as amended 2007) states that ‘appropriate medical treatment’ should have the purpose of alleviating a mental disorder.

Changes in mental health law do not always have the envisaged consequences. Studies from Canada, USA and Belgium have shown that legislation introduced to decrease the use of psychiatric detention resulted in increased rates of involuntary hospitalisation

Issues: Whether the detention of a patient who failed to engage with treatment was lawful; whether there was appropriate treatment; whether a Tribunal should have exercised its discretion to discharge; the proper approach to expert evidence.

the criteria for detention in s72 of the 1983 Act were made out, namely he was suffering from mental disorder (which it characterised as a psychopathic personality disorder), it was of a nature or degree which made it appropriate for him to be liable to be detained in a hospital for medical treatment

appropriate medical treatment was available

Passport

fforts to change the genetic makeup of a group or population almost always require third parties to be involved in the personal reproductive choices of individuals and couples. Someone besides the individuals making children has to set a policy and a standard. In our century these efforts have almost always incorporated force or coercion since individuals may not agree with the policy or third parties may seek to force their vision of improvement on an unwilling population.

or inequities that might arise from allowing the practice of eugenic choice

No moral principle seems to provide sufficient reason to condemn individual eugenic goals. While force and coercion, compulsion and threat have no place in procreative choice, and while individual decisions can have negative collective consequences, it is not clear that it is any less ethical to allow parents to pick the eye colour of their child or to try and create a fetus with a propensity for mathematics than it is to permit them to teach their children the values of a particular religion, try to inculcate a love of sports by taking them to football games, or to require them to play the piano. In so far as coercion and force are absent and individual choice is allowed to hold sway, then presuming fairness in the access to the means of enhancing our offsprings' livesit is hard to see what exactly is wrong with parents choosing to use genetic knowledge to improve the health and wellbeing of their offspring

I argue that eugenics is morally problematic and that we should distinguish “morally wrong” interventions from “morally problematic” interventions

Technological advances are likely to bring some of these moral disputes into sharper relief.

Marketing a practice is understood as removing obstacles to its broader acceptance. The aim is essentially similar to marketing a product. Someone who markets a product seeks to direct the attention of potential purchasers toward attractive features of the product and away from undesirable features. The success of a marketing effort is registered in increased sales. We measure the success of a moral marketing campaign in the uptake of the marketed behavior. This differs from the moral assessment of a practice, in which the aim is an accounting of the full range of associated moral issues. A moral assessor can arrive at a variety of conclusions. Perhaps the practice is morally obligatory for all. Perhaps it is morally permissible for some but obligatory for others. Earnest moral assessments may not make the most exciting reading in that they lack the daring of attempts to market new ways to produce human beings. But they should demonstrate a serious attempt to grapple with the wide range of moral considerations attendant on the assessed practice. Earnest moral assessments should highlight potential dangers. Practices such as eugenics that we recognize as potentially justified but especially dangerous should be approached with caution that runs counter to marketing.

While the science of genetics has increasingly provided means by which certain characteristics and conditions can be identified and understood, given the complexity of human genetics, culture, and psychology, at this point there is no agreed objective means of determining which traits might be ultimately desirable or undesirable. Some conditions such as sickle-cell disease and cystic fibrosis respectively confer immunity to malaria and resistance to cholera when a single copy of the recessive allele is contained within the genotype of the individual, so eliminating these genes is undesirable in places where such diseases are common