[Some examination and requests for "principles of the mental health care" submitted by the United Nations Commissions on Human Rights].

I do appreciate the "PRINCIPLES FOR THE PROTECTION OF PERSONS WITH MENTAL ILLNESS AND FOR THE IMPROVEMENT OF MENTAL HEALTH CARE" dated 5 February 1991 submitted by the Commission on Human Rights. To make it even more explicit, however, the following paragraphs should be added to two of the Principles: 1. As for Principle 11. 13, the requirement of informed consent by a personal representative should be prescribed in the case of a major medical or surgical procedure for an incompetent patient, in addition to the approval by an independent review body concerning such therapy, for the sake of consistency with Principle 11. 7 with regard to the right of privacy. 2. As for Principle 11. 15, the following three paragraphs should or may be added which have also been prescribed in "Principles for the Human Experiments" by the Japanese Society of Psychiatry and Neurology (1973), for the sake of consistency with Principle 11.7 with regard to the right of privacy and Principle 11.4 providing for the special protection of an incompetent patient: 2. 1 The requirement of informed consent by his/her personal representative should be prescribed in a case of clinical trials or experimental treatment for an incompetent patient. 2. 2 Intrusive and irreversible clinical trials and experimental treatment should never be carried out on a patient who is an involuntary patient in a mental health facility and they may be carried out on any other patient only where an independent external body has satisfied itself that there is genuine informed consent of the patient. 2. 3 It may be better to add the following paragraph: "clinical trials and experimental treatment shall never be carried out on an incompetent patient which are not necessary for the therapy of his/her disease or which are possible on a normal healthy person or a mentally ill patient having the ability to give informed consent."