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Deprivation of liberty in hospital: the MHA versus DoLS dilemma

Published online by Cambridge University Press:  30 August 2024

Jeremy Cave*
Affiliation:
Specialty registrar in general and older adult psychiatry (Specialty Trainee Year 5, ST5) with the Psychological Medicine Service, Royal Berkshire Hospital, Reading, UK.
Alex Ruck Keene
Affiliation:
Specialist mental capacity barrister at 39 Essex Chambers in London, UK. He is also a visiting professor at King's College London, UK, and a visiting senior lecturer at the Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
Matthew Lowe
Affiliation:
Consultant liaison psychiatrist with the Psychological Medicine Service, Royal Berkshire Hospital, Reading, UK. He is the Core Psychiatry Training Programme Director for Thames Valley Deanery, Oxford, UK.
*
Correspondence Jeremy Cave. Email: jeremy.cave@berkshire.nhs.uk

Summary

When admitting patients to hospital and treating them, psychiatrists and other health professionals may need to deprive them of their liberty. Where this occurs, professionals will need to work within a statutory framework to practice legally and protect their patients’ right to liberty under Article 5 of the European Convention on Human Rights. Within England and Wales, some clinical scenarios will require a choice to be made between the Mental Health Act 1983 (MHA) and the Mental Capacity Act 2005 (MCA) and its Deprivation of Liberty Safeguards (DoLS). This choice can be complex, is often overlooked and frequently misunderstood in clinical practice. Deciding between the two frameworks must be done on a case-specific basis. With the use of code of practice guidelines, case law and an unfolding clinical scenario we aim in this article to support clinicians in taking a clear-sighted approach to the dilemma and the factors to consider when deciding between the two regimes.

Type
Article
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists

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