Angry Doctor

Sunday, April 08, 2007

Mental Capacity Act 3

angry doc was hoping to take it easy over the Easter weekend, but the hits just keep coming...

From Dr Crippen, he learns of this story concerning the Mental Capacity Act in the UK:


The Act will give legally binding force for the first time to advance directives - or 'living wills' - under which patients can set down their wish to refuse treatment if they become seriously or terminally ill. In a living will, a patient can tell doctors to withdraw treatment so that they die as a result. During the passage of the Bill through Parliament the Government insisted that the practice did not amount to euthanasia. But some doctors insist that if they deliberately withheld food and fluid from a person who would not otherwise die they would be complicit in 'euthanasia by omission' or assisting in a suicide. Doctors must get a second opinion before deciding to withdraw artificial nutrition and hydration from a patient who is not close to death. There are also new provisions for patients to give 'lasting powers of attorney' to a friend or relative. This 'attorney' would be able to instruct doctors to let the patient die if they became incapacitated. Those refusing to obey the instructions would be open to prosecution for assault. Doctors or nurses could also be accused of 'wilfully neglecting' incapacitated patients and punished with up to five years in jail.

Will doctors in Singapore face a similar situation?

angry doc doubts it.

Given that the proposed Mental Capacity Bill is meant partly to address a lack in the Mental Disorders and Treatment Act (MDTA) by allowing patients to appoint someone with the power of attorney in the event that he loses his mental capcity, it is likely that the following clause from the MDTA will also apply:

Provision in case of cruel treatment or neglect of persons of unsound mind.33.

(1) If it appears to a Magistrate on the report of a police officer or on the information of any person that any person supposed to be of unsound mind is not under proper care and control or is cruelly treated or neglected by any relative or other person having the charge of him, the Magistrate may send for the person supposed to be of unsound mind and summon the relative or other person as has or ought to have the charge of him, and the Magistrate may after due inquiry make an order for the person to be sent to a medical officer at a mental hospital for treatment and the medical officer may thereafter act in accordance with section 35.

In addition, the MCYS press release on the MCA also states that the proposed Bill will:

"be guided by the principle that decisions made on behalf of the person must be done for his best interests,"

and that:

"Donees will be given statutory protection for their actions as long as they act within the ambit of the legislation. At the same time, safeguards will be introduced to ensure that the decision makers do not abuse their powers."

Still, if you feel worried enough by the proposed MCA, you might just want to send your feedback to the MCYS.



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