self-determination

A recent scenario gives me cause to vent. But also to raise for discussion the ethically debatable issue of ‘where to draw the line?’ when it comes to detained mental health treatment. The Shrink raises similar issues in his blog on issues of capacity and Advanced Directives.

My scenario revolves around Pt X who has a long standing diagnosis of schizophrenia. Now this in itself is a load of crap. He does however have some educational deficits, a limited ability to cope with stress and possibly an alcohol induced dementia. Mostly these are environmentally and culturally within the norm for his social group as such presentations are widespread amongst the communities from which this man hails.

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When I trained as a nurse, I recall the ongoing debate of the ‘theory/practice gap’. In the advent of the Health & Safety turbo-charged steamroller (recently convereted here to run on “Duty of Care” fuel), over the last 20 years or so, I would like to declare the “panic/common-sense gap” our new clear winner.I know I’m not the first to post on this topic, and surely am not the only one to have noticed or take issue with this. However, I am interested in the international perspective on this and will state from the outset, I’ve never seen in-patient healthcare quite so bad as I have where I am for being a Nanny State & Big Brother combined.

Health & Safety will hereafter be referred to as H&S (or UB, for “utter bollox”, depending on context and my mood).  Read the rest of this entry »