Scottish Council on Human Bioethics

15 Morningside Road, Edinburgh EH10 4DP, Tel: 0131 447 6394 or 0774 298 4459

29 June 2004

Consultation response to the Scottish Executive, Health Department

Consultation Paper on the Mental Health (Care and Treatment) (Scotland) Act 2003: Code of Practice - Volume 1

General Remarks:

The Scottish Council on Human Bioethics (SCHB) is of the view that the Scottish government should ensure that it respects the following international legislation. In addition, it should ensure that the language and expressions used in these international texts are similar to those of any future Scottish legislation in order to avoid misunderstandings and confusion:

United nations

Declaration on the Rights of Mentally Retarded Persons1
Adopted and proclaimed on 20 December 1971

Principles for the protection of persons with mental illness and the improvement of mental health care2
Adopted on 17 December 1991

Declaration on the Rights of Disabled Persons3
Adopted and proclaimed on 9 December 1975

Council of Europe

Draft Recommendation on the protection of the human rights and dignity of persons with mental disorder4
Forthcoming

Draft Protocol on Biomedical Research5
Forthcoming

Draft consultation response on behalf of the Scottish Council on Human Bioethics

Note: Not all questions will be addressed

Chapter 2 - Patient Representation

Paragraph 46:

The SCHB concurs that if a patient indicates that an advance statement should be withdrawn, all procedures related to the advance statement should be immediately interrupted until the provisions set out in section 275(3) are addressed.

Paragraph 72:

The SCHB is of the view that the witness of an advance statement should never be the person called upon to administer treatments. This may indeed create a conflict of interest.

Chapter 10 - Medical Treatment

Paragraph 24

The SCHB is of the view that patients who are incapable of consenting should never be subject to neurosurgery. This is in conformity with Article 28 (Specific treatments) of the forthcoming Council of Europe Recommendation on the protection of the human rights and dignity of persons with mental disorder. Such a treatment should only be carried out if the person concerned has given free, informed and specific consent in writing. Moreover, neurosurgery should not be used in the context of a person being placed into a medical institution without his or her consent because of the difficulty of ensuring that he or she has given consent to such an intervention in those circumstances.

If informed consent is given by the patient, then the treatment should be fully documented and recorded in a register.

Paragraphs 27-34

The SCHB notes that Electro-convulsive therapy treatment should be fully documented and recorded in a register.


1 Declaration on the Rights of Mentally Retarded Persons: http://193.194.138.190/html/menu3/b/m_mental.htm

2 Principles for the protection of persons with mental illness and the improvement of mental health care: http://193.194.138.190/html/menu3/b/68.htm

3 Declaration on the Rights of Disabled Persons: http://193.194.138.190/html/menu3/b/72.htm

4 Draft Recommendation on the protection of the human rights and dignity of persons with mental disorder: http://www.coe.int/T/E/Legal_affairs/Legal_co-operation/Bioethics/Activities/Psychiatry_and_human_rights/INF_2004_5e%20psychiatrie%20projet%20rec%20&%20ER.pdf

5 Draft Protocol on Biomedical Research http://www.coe.int/T/E/Legal_affairs/Legal_co-operation/Bioethics/Activities/Biomedical_research/CDBI-INF(2003)6eREV.pdf