By Jill Peay
Within the box of psychological wellbeing and fitness legislations, we entrust judgements with effects of the maximum gravity - judgements approximately obligatory clinical therapy and the lack of liberty - to medical professionals and authorized social employees. but, how do those non-lawyers make judgements the place the legitimacy of these judgements derives from legislations? This e-book examines the sensible, moral and criminal terrain of duo-disciplinary decision-making: given exact situations, what dilemmas do psychiatrists and authorized social staff come upon, do they succeed in a similar or related judgements and, such a lot significantly, how are these judgements justified? At a time of ferment in psychological healthiness legislations, this publication, via its narrative layout, offers a greater figuring out of the dilemmas posed.
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In discussion it emerged that the ASW had a caseload with a large proportion of patients with a forensic history. It was commonplace to him for them to use cannabis and carry knives. In contrast, the psychiatrist said that it was ‘unusual’ for any of his patients to have convictions. Although his concerns were driven by the possibility of something going wrong—‘if something happens, something goes wrong, it’s me that gets held responsible and therefore I’ve got to satisfy myself’—it was also apparent that his threshold of what might go wrong was set very low.
One needs to take that into account, because in a way that is protection of the public as well. 4 A Counter-intuitive Outcome—Clinical Risk Trumps The discussion started with the psychiatrist (who was opting for a section 3 admission) making an authoritative statement about Mr Draper’s clinical condition: 24 Robert Draper: A Case for Admission? He seems to have a recurrence of his psychosis, he has hallucinations, he’s obviously irritable with our visit and if the reports of the neighbours are valid, he has been disruptive and disturbed.
14 Robert Draper: A Case for Admission? —Is there evidence in the presenting history to sustain a belief in any of these risks to a degree that would satisfy the terms of the 1983 Act? However, as the Act fails to specify any particular threshold that has to be satisfied before the presence of a risk meets the notion of ‘necessity’, the terms remain a matter of individual interpretation. For this reason they are also vulnerable to an understandable tendency for professionals to find them satisfied by meagre evidence in circumstances of uncertainty.