7.4.1 Human Rights Legislation

Human Rights Legislation as it Effects Patients and Psychiatric Practice

The United Kingdom has a strong tradition of upholding human rights, including the rights of individuals who are receiving psychiatric care. UK human rights legislation has evolved over time to ensure that the rights of patients are protected and that psychiatric practice is carried out in accordance with these rights.

One of the key pieces of legislation in this area is the Human Rights Act 1998, which incorporates the European Convention on Human Rights (ECHR) into UK law. The Act sets out a range of rights and freedoms, including the right to life, the right to respect for private and family life, the right to freedom of thought, conscience, and religion, and the right to freedom of expression. These rights apply to all individuals, including those who are receiving psychiatric care.

Mental capacity act 2005:

Another important piece of legislation is the Mental Capacity Act 2005, which sets out the legal framework for making decisions on behalf of individuals who lack the capacity to make decisions for themselves. The Act establishes a set of principles and procedures for making decisions in the best interests of the individual, taking into account their wishes, feelings, beliefs, and values. The Act applies to individuals over the age of 16 in England and Wales.

The Act is underpinned by a set of five key principles:

• Presumption of capacity — a person is assumed to have capacity unless it is established that they lack capacity.
• All practical steps taken to allow autonomy — a person is not to be treated as unable to make a decision unless all practicable steps to help him to do so have been taken without success.
• Allow unwise decisions — a person is not incapable merely because they make an unwise decision.
• Best interests — an intervention under the Act on behalf of a person who lacks capacity must be in their best interests.
• Least restrictive option — any intervention under the Act should restrict as little as possible their basic rights and freedoms.

In addition to these legislative frameworks, there is a range of codes of practice and guidelines that are designed to ensure that psychiatric practice is carried out in accordance with human rights principles. For example, the Code of Practice to the Mental Health Act 1983 provides guidance on how to ensure that the rights of individuals who are detained under the Act are protected.

It is important for psychiatric practitioners to be aware of these legislative frameworks and guidelines, and to ensure that their practice is conducted in accordance with them. This includes ensuring that patients are provided with information about their rights, that they are involved in decision-making processes, and that their autonomy and dignity are respected at all times.

Ethical Frameworks:

This table summarises key ethical documents and their relevance to medical research, highlighting the essential principles and guidelines that govern the ethical conduct of studies involving individuals:

Document	Year Established	Key Focus	Relevance to Psychiatry Research
The Belmont Report	1979	Ethical principles of respect for persons, beneficence, and justice.	Guides protection of psychiatric research participants, especially in informed consent, risk-benefit assessment, and fair subject selection.
The Declaration of Helsinki	1964 (revised multiple times)	Ethical principles for human research, emphasizing informed consent, scientific rigor, ethical review, and balance of risks and benefits.	Mandates careful consideration of risks and benefits in psychiatric research, especially for vulnerable populations.
The Nuremberg Code	1947	Ethical principles for human experimentation, including voluntary consent, avoidance of unnecessary suffering, and the right to withdraw.	Emphasizes the importance of voluntary participation and informed consent in psychiatric research, considering the potential impaired decision-making capacity.
The Geneva Convention	1949 (latest update in 2005)	Humanitarian treatment in war, including humane treatment and prohibition of torture or degrading treatment.	Ensures humane treatment and dignity of individuals with mental health conditions in research, aligning with human rights standards.
The International Covenant on Civil and Political Rights	1976	Civil and political rights, including privacy, and protection against inhuman treatment.	Stresses respecting the privacy and dignity of psychiatric research participants and protecting them from inhuman treatment.

References:

1. The Human Rights Act 1998. (1998). Retrieved from https://www.legislation.gov.uk/ukpga/1998/42/contents
2. Mental Capacity Act 2005. (2005). Retrieved from https://www.legislation.gov.uk/ukpga/2005/9/contents
3. Department of Health. (2015). Code of practice: Mental Health Act 1983. Retrieved from https://www.gov.uk/government/publications/code-of-practice-mental-health-act-1983