10 Consent to treatment
- What happens when I need treatment?
- How does my doctor decide?
- What kinds of treatment can I have?
- How can I give my views?
- What should my doctor do?
- What are the special rules about treatment?
- Can I be forced to have treatment?
What happens when I need treatment?
If you consent
If you consent to have treatment, this means you agree. You are a "voluntary patient". You cannot be given treatment you do not want.
If you do not consent
You may not want the treatment or you may be too ill to decide. The new law says when you can be given treatment even if you do not want it. This is called compulsory treatment.
If you are unable to consent
You may be treated under a new law which helps you when you are unable to decide things for yourself. This is the Adults with Incapacity Act.
How does my doctor decide I need compulsory treatment?
Sam has a mental disorder. His doctor, Dr Rezal thinks that if she has treatment it will help her. She also thinks Sam will not be safe if she does not have treatment. Sam is too ill to decide so Dr Rezal decides to use the special powers in the new law.
You can be given compulsory treatment if you are under one of these orders:
- An emergency detention certificate
- You can be kept in hospital and given treatment for no more than 3 days.
- A short-term detention certificate
- You can be kept in hospital and given treatment for up to 28 days.
- A compulsory treatment order
- You can be given treatment if the Tribunal has agreed.
What kind of treatment can I be given?
How can I give my views?
Your doctor should think about your needs and:
- listen to you, your carer, your named person, independent advocate, or guardian
- read your advance statement when you write down how you would like to be treated if you become ill in the future
- give you information about the treatment
- help you to decide.
Independent advocate: someone who helps you say what you think about your treatment. They are called 'independent' because they are not tied to other services. Your doctor, hospital or social work department should help you find an independent advocate.
Named person: someone you choose to look out for you if you have to have treatment. They help to make decisions about your care and treatment.
What should my doctor do?
- Your doctor should decide if you are able to agree to your treatment and you should agree in writing.
- If your doctor thinks you are not able to agree he/she should explain in writing:
- why you are not able to decide
- how the treatment should help you.
- He/she can then give you the treatment and explain the reasons in writing.
Dr Rezal talks to Sam and his independent advocate Harry. Harry helps Sam to explain what he thinks to the doctor. Dr Rezal decides that Sam is not able to agree to the treatment. She explains in writing why she thinks this. She also explains how the treatment will help Sam.
What are the special rules about treatment?
The law has special rules about some treatments. For example:
- When your doctor wants to continue your medicine after 2 months.
- When you are not eating because of a mental disorder, you may be fed by a tube into the stomach.
- When your doctor wishes you to have Electro-Convulsive Therapy ( ECT) You cannot be given ECT if you are able to decide and you do not want it.
For these treatments your doctor should make sure that:
- the treatment is the best thing for you
- you are able to agree
- you agree in writing.
If you are not able to agree or do not want to agree, a second doctor must examine you and agree. This doctor will be appointed by the Mental Welfare Commission.
Mental Welfare Commission: the organisation that looks after those who need help because of a mental disorder. They make sure all treatment follows the law. You can speak to them at any time if you are unhappy about your care and treatment.
Neurosurgery is an operation on the brain. If your doctor wants to do this:
1. He/she must make sure that it is the best thing for you. He/she must also make sure that you are able to agree in writing.
2. A second doctor must also say it is the best thing for you and that you are able to agree in writing.
Two people (not doctors), chosen by the Mental Welfare Commission, must say that you are able to agree in writing.
If your doctor thinks that you are not able to agree, you can only be given the treatment if:
- You do not resist the treatment.
- A second doctor and two other people (not doctors) chosen by the Mental Welfare Commission, agree that it is the best thing for you.
- The court agrees.
If you are held in hospital, you can be given treatment to:
- save your life
- stop your illness getting worse
- stop your suffering
- stop you from being violent
- stop you from hurting yourself or someone else.
The doctor must tell the Mental Welfare Commission and explain why you needed the treatment.
Can I be forced to have treatment?
If you are in hospital for compulsory treatment:
- force can only be used if necessary.
If you are in your own home:
- force cannot be used to give you treatment.
If you are on a compulsory treatment in the community:
- you can be taken to hospital and force can be used.
If you are unhappy about the use of force in your treatment, you can complain. Your named person or independent advocate can help you.
What if I do not agree with my treatment?
- You should talk to your doctor. Your named person or your independent advocate can help you. Your doctor should tell why he/she thinks the treatment is the best thing for you.
- If you still do not agree you can ask the Mental Health Tribunal to decide.
- If you want to do this you can ask a solicitor for advice. You can get legal aid to pay for the solicitor's help.
Mental Health Tribunal: the organisation that decides about the compulsory treatment of people with mental disorder.