Consent Needed for Treatment of Psychiatric Patients?

Debbiee thumbnail
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Posted: 12 years ago
#1

Consent Needed for Treatment of Psychiatric Patients?

Treating a patient without his/her knowledge or treating forcibly is unethical. Also there could be chances that someone takes advantage of this and there could be many loopholes.

However in movies like "Bhool Bhulaiya" it's shown happening.

As you said it depends on the condition of the patient; whether he/she is capable enough to take decision on his/her behalf plays vital role here. If someone is capable of harming him/herself or others under mental-illness then the family may take decision of treatment on his/her behalf. Again this has to be decided by the medical laws.

As Sanchi tried suicide and caused havoc in Singh as well as Sekhar's lives it cannot be considered as a personal decision. If not treated she may harm more people.


If I remember correctly even the judge had advised Sekhars to get her treated for her mental illness.



Here is an interesting medical article on this theme https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031933/


Here are some information from this article.

Who takes the decision? - Need for a substitute decision-maker

Person incapable of consenting to treatment, a substitute decision-maker (SDM) interested in his/her welfare will make a treatment decision on his behalf. In this process one needs to take into account his wishes before he was found incapable.

Factors to be considered for an informed decision by SDM-

1.1.Nature of the treatment: what it is and what it involves

2.2. Expected benefits of the treatment

3.3. Potential or likely risks of the treatment

4.4. Potential or likely side-effects of the treatment

5.5. Other treatments or therapies that may be available

6.6. What could happen to the patient if the treatment is not given

There are, however, many instances in which medication is given without consent, covertly or otherwise, in all vulnerable patient populations whose "best" interests are being decided by a variety of surrogates.

Medical laws are still not very strong in India as they are in west. They are still in formation

Edited by Debbiee - 12 years ago

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Sudharies thumbnail
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Posted: 12 years ago
#2
Debbie, bv cvs coudnt possibly take these facts into account while making their story line,
if yes they should consider many such facts and logics which they've turned blind eye.

For ex No govt official can be transferred to his hometown., but cvs did. 😆
As far as sanchi's treatment is concerned nobody is gonna complain, since everybidy want her to be cured at the earliest...
Edited by Sudhaiyer86 - 12 years ago
Debbiee thumbnail
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Posted: 12 years ago
#3

Originally posted by: Sudhaiyer86

Debbie, bv cvs coudnt possibly take these facts into account while making their story line,
if yes they should consider many such facts and logics which they've turned blind eye.

For ex No govt official can be transferred to his hometown., but cvs did. 😆
As far as sanchi's treatment is concerned nobody is gonna complain, since everybidy want her to be cured at the earliest...


Thanks Sudha.

However I did not write this to prove myself of CVs right.

I wrote this to help many people who are suffering daily with a Sanchi-alike brat at their house and think that punishment would sort out this. What she is suffering from is mental illness and should be treated ASAP. Even the judge had advised the Sekhars for doing so.


After writing "Gone with the wind"; many readers had written to me their stories how they suffer for an insane person person in their life. This article could help them 😊
GoodDoc_2105 thumbnail
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Posted: 12 years ago
#4
It has not been established whether she has psychiatric disorder or not in Sanchi's case.
Psychiatric evaluation was not done.The doctor who treated her wounds at the time of her suicide attempt only suggested counseling.

This particular psychiatrist has prescribed medications for Sanchi without even doing a psychiatric evaluation.

Sanchi's case doesn't warrant enforced treatment.And medicines can be given to her only with her consent and it becomes the responsibility of the family to convince her as well as the psychiatrist/psychologist to convince her to take help.

Enforced treatment with informed consent from the nearest relative is applicable only in case of patients who are dangerous to themselves and causing bodily harm to the people near them and exhibit violent behaviour and who are not in a position to understand what is happening around them not conscious of their surroundings and fail to understand or unable to communicate.
Sanchi definitely is not in such a state.

Going by Sanchi's behaviour - It doesn't look like she has mental illness.What she has is a borderline personality disorder probably which makes it difficult to cope with stressful condition she faces in life.For that she needs counseling mainly and some medication to soothe her probably.For that her consent is needed.

Her suicide attempt is more of her reaction to a stressful condition rather than a result of a mental illness.

Sanchi doesn't have a mental illness but a borderline personality disorder from what they have shown.

She cannot be treated without her consent.

I do not think what is given in that piece of literature is applicable in Sanchi's case.

I am not a psychiatrist and from what little I have learnt in undergraduate medical course way back this is what I understand about Sanchi.
brick_red thumbnail
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Posted: 12 years ago
#5
Good topic, Debbie.
I'm not sure about the ethics on treating Sanchi without her consent. But I'm very sure that, if they are going to give the medicine, only Sanchi's parents should do that. In case if Sanchi is declared as unfit to make decisions by a doctor, I think only Alok or Ira has the moral/legal/social right to give medication to Sanchi.

Through any angle you look at it, Anandi giving medicines to Sanchi is not right.

From my personal experience, I knew a maid who suffered from constant headaches. She used to take 2-3 strong pain killers a day, but of no use. She could not do her daily work and earn money and that caused more problems in her life. When taken to a hospital, Doctor told, actually she did not have headaches, but she was suffering from depression. (It was possible considering her family situation). But this lady had not heard of depression. And talking to her about that, would possibly drive her into further depression, because she might mistake depression with serious mental illness! So doctor suggested to give her a mild dose of depression medicine for a long period of time without her knowledge. So the well wishers passed the medicine to her as some special headache medicine and that did the work. Lady felt better and her life improved and she became happy. Was the whole thing ethical?? But what options were there?


In Sanchi's case, there are many options. Sanchi is in a position to make an informed choice. Why her parents are not talking to her? If nothing is working, they should lovingly tell Sanchi to leave the house. Let her be on her own. Sanchi obviously has some problem. But Shekhars also have problem in letting her go. Why do they try to control Sanchi? From the beginning, Shekhars are adamant in bringing Sanchi to their line of thinking. But Why?? Sanchi should have the freedom to make her decisions and Shekhars should let her face the consequence of her decisions. Nobody, other than Sanchi should be responsible for Sanchi's actions. But what the Shekhars are doing??? Example. Sanchi went to BH fully drunk. Why did Ira question CM that how did she let Sanchi go out of the house? Sanchi wore short skirt to a party, why did Ira question Anandi about that? Sanchi is an adult woman, and she should be treated as an adult.
tinoo thumbnail
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Posted: 12 years ago
#6

Originally posted by: brick_red



Through any angle you look at it, Anandi giving medicines to Sanchi is not right.


😆😆😆 I found this funny. I do agree anandi has long time crossed her boundaries and now just keeps on taking more and more liberties.

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