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Mired in confusion: making sense of the Deprivation of Liberty Safeguards

Mired in confusion: making sense of the Deprivation of Liberty Safeguards IntroductionThere is uncertainty about how to identify deprivation of liberty and the interface of the Mental Health Act and Mental Capacity Act Safeguards.ObjectiveTo increase current understanding by exploring how an expert legal panel interpret existing case law relating to deprivation of liberty in the clinical setting.DesignClinical vignettes of real patients were used to explore lawyers' thinking about important factors that: (1) distinguish lawful restriction from deprivation of liberty and (2) govern the choice between safeguard regimes when there is deprivation of liberty. The relative importance of such factors was discussed in a consensus meeting using a modified nominal group approach.Participants and settingSix eminent barristers and solicitors with expertise in mental health law attended a consensus meeting after making individual judgements about vignettes describing the situations of 28 incapacitated patients who had been admitted informally to a range of psychiatric inpatient units in South East London.ResultsLawyers attributed key importance to a patient's ‘freedom to leave’ and suggested that patients' subjective experiences should be considered when identifying deprivation of liberty.ConclusionsClarification of deprivation of liberty and its safeguards will develop with future case law. Based on current available case law, the lawyers' expert views represented a divergence from Code of Practice guidance. We suggest that clinicians give consideration to this. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Medicine, Science and the Law SAGE

Mired in confusion: making sense of the Deprivation of Liberty Safeguards

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References (10)

Publisher
SAGE
Copyright
© British Academy of Forensic Sciences
ISSN
0025-8024
eISSN
2042-1818
DOI
10.1258/msl.2011.010122
pmid
22021593
Publisher site
See Article on Publisher Site

Abstract

IntroductionThere is uncertainty about how to identify deprivation of liberty and the interface of the Mental Health Act and Mental Capacity Act Safeguards.ObjectiveTo increase current understanding by exploring how an expert legal panel interpret existing case law relating to deprivation of liberty in the clinical setting.DesignClinical vignettes of real patients were used to explore lawyers' thinking about important factors that: (1) distinguish lawful restriction from deprivation of liberty and (2) govern the choice between safeguard regimes when there is deprivation of liberty. The relative importance of such factors was discussed in a consensus meeting using a modified nominal group approach.Participants and settingSix eminent barristers and solicitors with expertise in mental health law attended a consensus meeting after making individual judgements about vignettes describing the situations of 28 incapacitated patients who had been admitted informally to a range of psychiatric inpatient units in South East London.ResultsLawyers attributed key importance to a patient's ‘freedom to leave’ and suggested that patients' subjective experiences should be considered when identifying deprivation of liberty.ConclusionsClarification of deprivation of liberty and its safeguards will develop with future case law. Based on current available case law, the lawyers' expert views represented a divergence from Code of Practice guidance. We suggest that clinicians give consideration to this.

Journal

Medicine, Science and the Law – SAGE

Published: Oct 1, 2011

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