Richardson Genevra
Queen Mary, University of London, UK.
Mod Law Rev. 2002 Sep;65(5):702-23. doi: 10.1111/1468-2230.00404.
The law in England and Wales governing both the provision of medical care in the case of adults with incapacity and the provision of care and treatment for mental disorder presents serious problems for the principle of patient autonomy. The adult with incapacity has no competence either to consent to or refuse medical treatment but the law provides no statutory structure for substitute decision making on that adult's behalf. On the other hand the law does allow a person with mental disorder to be treated for that disorder despite his or her competent refusal. The nature of these inconsistencies is considered and the implications which flow from the singling out of mental disorder are examined with reference to experience in two Australian jurisdictions. The current proposals for reform of the Mental Health Act are then considered in the light of the conclusions drawn.
英格兰和威尔士关于为无行为能力成年人提供医疗护理以及为精神障碍患者提供护理和治疗的法律，给患者自主权原则带来了严重问题。无行为能力的成年人既无能力同意也无能力拒绝医疗治疗，但法律并未提供法定框架来代表该成年人进行替代决策。另一方面，法律确实允许对患有精神障碍的人进行治疗，尽管其有行为能力拒绝。本文探讨了这些不一致之处的性质，并参照澳大利亚两个司法管辖区的经验，审视了将精神障碍单独列出所产生的影响。然后根据所得出的结论，对当前《精神健康法》的改革提案进行了审议。
