For fuck’s sake. We are talking about people who do have a major mental illness, who cannot make a rational decision about treatment, and we know that because they are an otherwise healthy person who has tried to kill themselves.
If you refuse to treat someone in that sitiuation, when it is your professional duty to do so, then you are responsible for their death.
Do you get that? Trying to kill yourself, absent a terminal illness, proves you are mentally ill. It’s the same reason you are allowed to treat a child against their will, for example.
In this case, no I don’t, as my “guesswork” is that I “guess” that it’s neither moral nor legal to allow someone to die from self-inflicted injuries if you have a responsibility to treat them - as any medical professional does.
It’s extremely disturbing that someone who claims to be a medical professional thinks it’s OK to let people who are not in their right minds bleed out or die of poisoning because they might want that… Or do you get your kicks seeing mentally ill people suffer?
No medic in the UK would treat a competent person withholding consent. Some but not all mental disorders may result in lack of competence. Most mental disorders do not result in lack of competence.
I did this as a job for thirty years and my partner still works in Emergency Psychiatry. I used to teach competence, consent and mental disorder at university level for nursing students over many years and have followed the gradual changes in the nuances of the law.
You are mistaking personal belief and moral certainty for the real world.
Doctors were forced to allow a suicidal woman who had swallowed anti-freeze to die, because she refused medical help.
Kerrie Wooltorton, 26, of Norwich, had also made a “living will” requesting no intervention if she tried to take her own life, a Norwich inquest heard.
Doctors would have risked breaking the law by treating her, the coroner said.
The Norfolk and Norwich University Hospital said Miss Wooltorton was conscious and doctors were convinced of her mental competence.
She died four days after being admitted to the hospital.
Well, that makes it alright then, no? Did you ever provide any evidence that any of these states actually let folks die? If so just tell me the post number as I’d be interested to see how this works in practice in the ‘other western liberal democracies’ who are oh so much more civilized than we barbarian Americans.
It’s not just western liberal democracies. Lots of great people were certain their beliefs were right and it didn’t matter how many people died because of those beliefs: Hitler, Stalin, Mao, Pol Pot, Kim Il Sung, Saddam Hussein, Osama bin Laden. Pjen is standing on the shoulders of giants.
Those doctors are responsible for her death, then, and should no longer be working in the medical profession, at the very least.
It may be that the law is as you say - though I doubt it, and I doubt that any competent psychiatrist would say that someone who did what she did was responsible for her actions - but for you to accept it rather than fight against it, fight to do your job and save lives, is - as I said before - monstrous.
You are entitled to your opinion about what should be done. You are entitled to argue for it against other views. What you are not entitled to do is to claim that something that is the case is not the case or something that is not the case is the case unless you produce evidence.
As I have pointed out, this is my profession about which I am expected to have professional knowledge. Not only that but I was an educator teaching this very subject to nurses at University level.
I can assure you that having a mental disorder (a medical matter) and being detainable or losing capacity (which are legal matters) are not co- terminus. Additionally acting to either kill oneself or attempt to kill oneself is not co- terminus with mental disorder.
In the case of someone who has self harmed, medical staff are required to comply with their professional ethics within the law.
The law on competence is quite clear. Competence describes how the law decides whether persons should or should not have control of their lives. This is measured partly by age (children are initially not competent, but develop competence between the ages of seven and eighteen years). Adults are assumed to be competent unless their ability to take responsibility is so impaired that the law requires other parties to act on their behalf through mental disorder of any kind.
Mental disorder is a legal concept separate from mental illness. Parameters of mental disorder (decided by lawyers) are separate from the parameters of mental illness (decided by doctors). It is possible to be mentally disordered without being mentally ill or to be mentally ill without being mentally so mentally disordered as to be detainable under the mental health law or have competence removed.
Competence is assumed in adults unless proved to be absent. Competence means that people have the ability to exercise an action whether or not they are actually able to exercise it.
For instance all adults are competent to decide whether or not to act in certain ways but their social situation (prisoner, soldier, professional etc.) may make the their actions not exercisable.
The law of consent is quite clear as is the law on mental disorder and the diagnostic criteria for mental illness to a certain extent.
The three categories overlap to a certain extent but are not co-terminus.
I posted cites way above for states that ban force feeding in the case of hunger strikes. Most legal systems based on English Common Law recognise the right of a competent individual to refuse medical treatment unless they are mentally disordered to such an extent that they lose civil competence.
Triage of patients in A&E following self harm involves complex medical, ethical and legal issues.
The first question is “is the patient compliant” - are they agreeing to the treatment- administration of antidote, stemming of blood flow etc. If so then treatment proceeds.
If the patient is incompetent or suffering from limited consciousness then treatment may be given without explicit compliance or consent as a matter of necessity.
If a patient refuses treatment, then an assessment must be made about their status under the mental health laws and under the law on competence. The mental health acts allow detention for treatment of illness under certain circumstances and the law on competence to decide on treatment of immediate trauma under the law on capacity.
A general medical doctor would usually call on Mental Health staff to assess whether an application to treat should be made under the mental health act if the person is refusing consent. If necessary they may refer to the courts to decide on competence.
Being mentally ill does not necessarily lead to detainability for treatment or loss of capacity to decide the course of their own life.
Such decisions are also made prior to admission to A&E by police and area medics. They have limited powers to force people to attend for treatment for competent persons.
These are not opinions but facts about the law and medical practice in the UK.
So your argument is that any moral code that differs however much from your own ideas is way down the slippery slope towards tyrants and mass murderers. It must be pleasant to be so assured that your beliefs are so correct.
You’re the one who seems too sure about your beliefs.
I’m the one who says that both sides make some valid points. Personal freedom is important. But life is important too. I try to find a balance between them.
I am certain in my ethics and understand how I reached those beliefs. I do not believe that others are wrong, merely that they have different ideas. It is similar to the abortion debate- there are differing approaches dependent on axiomatic beliefs; some take an extreme fundamental view whereas others tend towards pragmatism.
I believe there is a balance between sanctity of life and freedom of action. The concept of competence seems to me to be a pragmatic compromise.
To over-ride an adult’s autonomy in favour of an absolute right to life seems an extreme position. Do we make suicide illegal again?
Did you ever provide any evidence that any of these states actually let folks die? If so just tell me the post number as I’d be interested to see how this works in practice in the ‘other western liberal democracies’ who are oh so much more civilized than we barbarian Americans.