Decision-making capacity and the Victorian Mental Health Tribunal
Decision-making capacity and the Victorian Mental Health Tribunal
复制标题
决策能力和维多利亚州精神健康法庭
DOI：
10.19164/ijmhcl.v2017i24.685
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
C. Ryan
中科院分区：
文献类型：
--
作者：
C. Maylea;C. Ryan
《联合国残疾人权利公约》（CRPD）引发了世界各地对传统精神卫生法的重新思考。自澳大利亚批准《残疾人权利公约》以来，其八个司法管辖区中除其中一个外，其他所有司法管辖区都对心理健康立法进行了改革。这些措施的部分目的是为了遵守《公约》条款。本文探讨了澳大利亚第二人口大国维多利亚州推行的改革的意义和运作。我们首先描述新的 2014 年精神健康法案（维多利亚州）（澳大利亚）（该法案）中规定的非自愿治疗标准。然后我们认为，在下达非自愿治疗命令时，维多利亚州精神健康法庭（法庭）有义务仔细考虑一个人的决策能力，以确保以限制最少的方式提供治疗，并且仅在非常有限的情况下，在一个人有充分理由反对的情况下，才批准非自愿治疗。在确定了该法案的运作方式后，我们提出了两项实证研究，分析了法庭理由陈述的决定，以获得对该法案如何运作的一些了解。这些表明法庭很少考虑受审人的决策能力，而且即使考虑到这一点，相关信息也没有被保护性地使用，以维护有权拒绝治疗的权利。相反，法庭利用决策能力、洞察力或判断力的存在与否来确定一个人是否患有精神疾病或是否需要治疗以防止严重伤害。我们的结论是，法庭的做法不符合该法的原则，因此也不符合议会的意图。
The United Nations Convention on the Rights of Persons with Disabilities (CRPD) has led to a re-thinking of traditional mental health law around the world. Since Australia’s ratification of the CRPD, all but one of its eight jurisdictions have introduced reforms to mental health legislation. These are aimed, in part, towards compliance with the Conventions articles. This paper examines the meaning and operation of the reforms introduced in Australia’s second most populous state – Victoria. We first describe the criteria for involuntary treatment set out in the new Mental Health Act 2014 (Vic) (Austl.) (the Act). We then argue that when making an order for Involuntary Treatment, the Victorian Mental Health Tribunal (the Tribunal) is obliged to carefully consider a person’s decision-making capacity as part of ensuring that treatment is provided in the least restrictive way, and to only authorise the involuntary treatment over a person’s competent objection in very limited circumstances. Having established the way in which the Act should operate, we then present two empirical studies which analyse the decisions of the Statements of Reasons of the Tribunal to gain some appreciation of how the Act is working. These indicate that seldom does the Tribunal consider the decision-making capacity of people brought before it, and that, even when this is considered, the relevant information is not being used protectively so as to uphold a right to competently refuse treatment. Instead, the Tribunal uses the presence or absence of decision-making capacity, insight or poor judgement, to determine if a person is mentally ill or if treatment is required to prevent serious harm. We conclude that the Tribunal’s practice is inconsistent with the principles of the Act and consequently the intention of Parliament.