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Emergencies, general medicine, ‘community treatment orders’, and ‘psychiatric advance statements’ 

Emergencies, general medicine, ‘community treatment orders’, and ‘psychiatric advance statements’
Emergencies, general medicine, ‘community treatment orders’, and ‘psychiatric advance statements’

George Szmukler

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date: 10 December 2019

The implications of the Fusion Law for general medicine, especially inpatient care when non-consensual and involuntary treatment is being considered, are examined in this chapter. The new burdens posed by regulation can be minimized by making requirements essentially parallel ‘good practice’. Involuntary psychiatric treatment in the community under the ‘decision-making capability–best interests (will and preferences)’ principles of the Fusion Law would be substantially different from the way it is commonly instituted today. The Fusion Law offers an important place for ‘advance statements’ and ‘advance directives’, supporting respect for a patient’s beliefs and values (or ‘will and preferences’). Illnesses that impair decision-making capacity, but that are relapsing-remitting—such as the majority of mental illnesses—are good candidates for such advance planning, yet such measures have rarely been employed to date.

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