Psychiatrists appear in honourable courts as experts and testify, but do not know what happens later. I commend the investigators for exploring a hitherto unexplored topic in the Indian scenario,[10] which concerns senseless advocacy. [11] If a defendant has evidence that he or she was undergoing treatment prior to the crime, the attending psychiatrist may be summoned; In 32 out of 67 cases (47.76%), the treating psychiatrist was invited to appear. The time interval between the “visit to a psychiatrist” and the subsequent “date of the crime” ranged from 1 to 1800 days, which is alarming in that a PWMI can commit a crime immediately after the visit. In addition, if there is documentary evidence of mental illness, the probability (P < 0.012) of acquittal for mental illness is higher. Both in the cases where the honourable court found that no psychiatric evidence was necessary (24 cases) and in the six cases where the psychiatrist found that there was no mental illness, the accused was not acquitted of mental illness. The 16 of 56 accused (28.57%) who were believed by psychiatrists to have a mental illness were also acquitted of mental illness (P = 0.002). All 18 cases (17.65%) out of a total of 102 cases were acquitted on the grounds of mental illness. The judgment of the honourable high courts largely coincided with the judgment of the lower court and relied heavily on documentary evidence of mental illness. The opinion of psychiatrists was an important parameter, which is very encouraging. The results strongly highlight the need for appropriate documentation. The intersection of duty of care and the dignity of risk for those in need of support is a very grey area.
It can sometimes be difficult to decide which action is best for a particular person. Try to keep them safe instead of allowing them to grow, develop and learn from life. The first of the eight “guiding principles” of the UN Convention on the Rights of Persons with Disabilities states: “respect for inherent dignity, individual autonomy, including freedom of choice and independence of persons.” [18] The idea of the dignity of risk is inherent in the fact that life experiences are associated with an element of risk that even the best planning and support cannot eliminate. For example, a caregiver might recommend that a client switch to a diet with thickened fluids. If the customer refuses, employees can support their decision to continue eating solid foods by supervising them during meals and contacting them regularly afterwards to minimize risk. Allowing people being cared for to take risks is often seen as a conflict with caregivers` duty of care. It can be difficult to balance these competing considerations when formulating care policies and guidelines. [10] [2] [7] [11] [12] Given the NDIS`s focus on the selection and screening of persons with disabilities, it is essential that Interchange clearly understands the concepts of “duty of care” and “dignity of risk”. For example, if we have the dignity of the risk of smoking cigarettes, if we choose to do so, then those we support also have the dignity of the risk of making that choice. The patient-physician relationship is linked to the moral and ethical nature of confidentiality, particularly in mental health. This is one of the fundamental tasks of the psychiatrist. [1,6] In clinical practice, however, PWMI itself waives this confidentiality clause in certain situations.
In India, PWMs are usually accompanied by nurses. Few PWMIs want their information and diagnoses disclosed to these caregivers. As this was considered implied consent, this disclosure was made until some time ago in the absence of express written informed consent. A typical scenario would be that a woman who has been treated for psychiatric disorders in the past 10 years suddenly comes to the attending psychiatrist and reveals that she got married about a month ago and is now considering getting pregnant. Your spouse also wants to talk about the diagnosis, treatment, necessity and safety of psychotropic medications during pregnancy. Unfortunately, the spouse can use the disclosed information for any purpose (including divorce) and the lady can sue the attending physician for breach of confidentiality. Since the lady herself wants her information shared with her spouse and the confidentiality clause is violated, she must obtain her written consent, including permission to disclose what may be disclosed, and this must be documented in the patient`s notes. Such written authorization from the patient may protect the psychiatrist in court. Risk dignity refers to the legal right of everyone, including persons with disabilities, to make decisions and take risks in order to learn, grow and have a better quality of life. If you have any questions about due diligence or the dignity of risk, contact ISM staff today at 1800-954-559. We will do our best to answer your questions and provide clarification. Caregivers must consider the mental and physical abilities of the people they care for in order to make informed decisions about how to care for them.
However, there is a delicate balance between adequate assistance and removing the dignity of risk. Making mistakes and learning from trial and error are key factors in how we grow and develop in our formative years and throughout our lives. The dignity of risk is the fundamental human right that makes this process possible. Without ever being exposed to the potential for risk, we would not be able to reach our full potential. Due diligence refers to the caregiver`s responsibility to provide a person with a safe environment in which to live. Especially when working with people of all abilities, caregivers need to take extra precautions to address the mental and physical challenges of the people they care for. It is a legal term with a clearly defined meaning. Due diligence is the responsibility of organizations and their employees to ensure that they do not cause harm to the people they support. However, this does not mean that the organization must protect the person from himself. This means that we have the dignity to make our own decisions, and so do others. This means that everyone can take certain risks, learn from their mistakes and grow, and choose how they want to live their life. A person`s right to make decisions for their life is accepted until it is established that help is needed.
Where this line is drawn is determined by those who are legally responsible for the person, such as their family or a legally appointed guardian. “With rights comes responsibility!” “A person has a mental illness, is aware of it, is exercising their right not to seek treatment, commits a crime, attributes the crime to a mental illness, and does not take responsibility for the crime because it is due to mental illness.” An example in relation to disability would be that only a few patients with intact mental capacity have an idea of their mental illness, but exercise their “right to refuse treatment”. Therefore, they do not want to take responsibility for the treatment. However, in order to receive benefits, they “declare a disability” due to mental illness. How can such a person exercise their right to object to treatment? But at the same time claiming “benefits” related to his mental illness? For patients with severe intellectual disability, dementia, and obvious severe and persistent mental illnesses such as severe psychoses at risk of flight, few of my psychiatrist colleagues suggested the use of metal bracelets (kadas that are religiously acceptable) with engraved details (name, phone numbers, and address of the patient and caregiver) during an armchair discussion; Group; and implants, gadgets, watches and chips with GPS tracking device and trackers.