Treatment Without Consent: Law, Psychiatry and the Treatment of Mentally Disordered People Since 1845

365 Pages·1995·2.03 MB·English

by  Phil Fennell

TREATMENT WITHOUT
CONSENT
SOCIAL ETHICS AND POLICY SERIES
Edited by Anthony Dyson and John Harris
Centre for Social Ethics and Policy, University of Manchester
EXPERIMENTS ON EMBRYOS
Edited by Anthony Dyson and John Harris
THE LIMITS OF MEDICAL PATERNALISM
Heta Häyry
PROTECTING THE VULNERABLE
Autonomy and Consent in Health Care
Edited by Margaret Brazier and Mary Lobjoit
MEDICAL CONFIDENTIALITY AND LEGAL PRIVILEGE
Jean V.McHale
ETHICS AND BIOTECHNOLOGY
Edited by Anthony Dyson and John Harris
LIBERAL UTILITARIANISM AND APPLIED ETHICS
Matti Häyry
CONTEMPLATING SUICIDE
The Language and Ethics of Self Harm
Gavin J.Fairbairn
TREATMENT
WITHOUT CONSENT
Law, psychiatry and the treatment of
mentally disordered people since 1845
Phil Fennell
London and New York
First published 1996
by Routledge
11 New Fetter Lane, London EC4P 4EE
Simultaneously published in the USA and Canada
by Routledge
29 West 35th Street, New York, NY 10001
Routledge is an imprint of the Taylor & Francis Group
This edition published in the Taylor & Francis e-Library, 2004.
© 1996 Phil Fennell
All rights reserved. No part of this book may be
reprinted or reproduced or utilized in any form or by any
electronic, mechanical, or other means, now known or
hereafter invented, including photocopying and recording,
or in any information storage or retrieval system, without
permission in writing from the publishers.
British Library Cataloguing in Publication Data
A catalogue record for this book is available
from the British Library
Library of Congress Cataloguing in Publication Data
A catalogue record for this book has been requested
ISBN 0-203-41789-5 Master e-book ISBN
ISBN 0-203-72613-8 (Adobe eReader Format)
ISBN 0-415-07787-7 (Print Edition)
To Jenny and James, and to the memory of my parents,
Harold and Molly Fennell
This page intentionally left blank.
CONTENTS
A cknowledgements i x
I ntroduction 1
1 1 845–1853: THE BIRTH OF THE LUNACY
COMMISSION 14
2 1 853–1880: THE TRIUMPH OF NON-RESTRAINT? 2 4
3 C HEMICAL RESTRAINT 3 6
4 1 880–1913: THE RETURN OF RESTRAINT 4 7
5 S URGICAL TREATMENT AND CONSENT 6 4
6 T HE BOARD OF CONTROL AND STERILISATION OF
‘THE UNFIT’ 75
7 T HE BOARD OF CONTROL AND THE MENTAL
TREATMENT ACT 1930 104
8 T HE BOARD OF CONTROL AND TREATMENT FOR
MENTAL DISORDER, 1913–1930 117
9 T HE AGE OF EXPERIMENTATION: THE BOARD OF
CONTROL AND TREATMENT FOR MENTAL
DISORDER, 1930–1959 126
10 T HE AGE OF PSYCHOPHARMACOLOGY 14 8
11 T HE MENTAL HEALTH ACT COMMISSION AND
THE MENTAL HEALTH ACT 1983 167
viii TREATMENT WITHOUT CONSENT
12 T REATMENT WITHOUT CONSENT UNDER THE 1983
ACT 186
13 E MERGENCY SEDATION, SECLUSION AND
RESTRAINT IN CONTEMPORARY PSYCHIATRY 213
14 T REATMENT OF INCAPABLE PATIENTS WITHOUT
CONSENT UNDER COMMON LAW 228
15 C ODIFYING CLINICAL AUTHORITY 24 4
16 I NFORMAL COMPULSION: TREATING CHILDREN
WITHOUT CONSENT 264
C onclusion 27 2
T able of statutes 28 9
T able of statutory instruments 29 1
T able of cases 29 2
N otes 29 6
B ibliography 32 9
I ndex 34 4
ACKNOWLEDGEMENTS
My largest debts are to two people: first, my colleague and good
friend, Dr Clive Unsworth of Cardiff Law School, who has given
unstintingly of his time and unrivalled knowledge of mental health
legislation to offer constructive and inspirational criticism of draft
chapters; and second, Catherine Young of the School of Social and
Administrative Studies at Cardiff University for her invaluable and
patient advice, in helping me to devise a coding frame to enable the
data for the empirical study of statutory second opinions in Chap-
ters 12 and 13 to be analysed, as well as for her assistance in enter-
ing and retrieving the data. Peter Alldridge, and Professors Shelia
Maclean and Philip Bean have made many valuable suggestions.
My thanks are due to the Nuffield Foundation, whose small grants
scheme provided the necessary funding to carry out the empirical
study; to William Bingley, the Chief Executive of the Mental
Health Act Commission (MHAC) for arranging access to the data
and for his helpful advice at various stages of the research; to Ali-
son Cooney, the MHAC Administrative Manager for organising the
photocopying of the relevant reports; and to Andrew Kay at the
MHAC, who provided me with some of the more recent figures on
the total numbers of second opinions during the biennium 1991–
1993. Three Mental Health Act Commissioners, Dr Max Harper,
Professor Elaine Murphy, and Ms Elaine Rassaby were kind enough
to provide extremely useful comments on earlier drafts.
The research for the historical chapters of the book took me to a
large number of libraries and research archives, whose staff were
invariably helpful and friendly. These included the Public Record
Office at Kew; the Royal Commission on Historical Manuscripts;
the Radcliffe Camera; the Radcliffe Science Library; the National