Supervision and restriction of patients at home
Abstract
There are laws laid down in mental health legislation, which permit the detention of patients in hospital under clinical supervision. But there is no legislative provision for patients who are cared for at home in association with district nurses. The law relating to the care of such patients comes from the ordinary common law relating to duties of care and their associated standards, to consent to treatment and to confidentiality and privacy of information. Much of established English law is to be found in court decisions relating to claimants who have been in hospital. The law relating to the supervision of patients who are being cared for at home requires separate examination.
John Finch, a freelance journalist specialising in the law and ethics of healthcare, takes a look at some of the legal aspects of home care and treatment with a particular eye supervision and restrictions which need to be placed on liberty and movement which would not be required in the absence of vulnerability.
We begin with a story that will hopefully bear no relation to the professional experience of readers. A GP once told me of a call he received from a gentleman who requested a home visit ‘to have a word about Grandad’. The GP duly turned up and was ushered into the living room where the family was assembled. The same gentleman acted as family spokesperson and said to the doctor: ‘Well, you see, it’s that he’s getting on a bit and we think it’s time he went.’ ‘Went where?’ asked the doctor. Expecting some discussion about care homes or alternative accommodation, he received the laconic reply, ‘Well, just-er-gone’. While there are those who believe that going to A Better Place is something to be wished for, such a belief does not figure in a district nurses professional practice.
Asking precisely how the family wished to achieve their desired end, namely Grandad’s undesired end, the spokesperson said that was a matter for medicine. The doctor was led upstairs to take a look at Grandad. He was indeed bedridden because the family had ridden him there. He appeared to be in good spirits and in good health for someone of his age. He was propped up against the pillows with a TV and a copy of the Racing Post. He did not have any questions for the GP and was simply pleased to see a new face. The doctor and his deathwishing interlocutor returned downstairs, the GP explaining that families have no right under English law to do away with people they have had enough of.
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