Exceptions and Exclusions: The Right to Informed Consent for Medical Treatment of People with Psychosocial Disabilities in Europe

In: European Journal of Health Law
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  • 1 Maastricht University, Maastricht, The Netherlands
  • 2 University of Melbourne Law School, Faculty of Law, Monash University, Melbourne Social Equity Institute, University of Melbourne, Australia

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This article examines the relevant international law relating to informed consent to treatment for individuals with psychosocial disabilities and reflects on the protection offered in this respect by the European Convention on Human Rights (echr) and the Council of Europe Convention on Human Rights and Biomedicine. The article argues that while the un Convention on the Rights of Persons with Disabilities is beginning to influence case law of the European Court of Human Rights, only ‘weak’ protection has been afforded to people with psychosocial disabilities by the echr and the Court in relation to informed consent for medical treatment.

  • 1

    T. Minkowitz, ‘The United Nations Convention on the Rights of Persons with Disabilities and the Right to be Free from Nonconsensual Psychiatric Interventions’, Syracuse Journal of International Law and Commerce 34(2) (2007) 404-428, 427. See also United Nations News Centre, 2006, ‘Lauding Disability Convention as ‘Dawn of a New Era’, un Urges Speedy Ratification’, 13 December. www.un.org/apps/news/story.asp?NewsID=20975#.VY-Of_mqqko, retrieved 28 June 2015. For an overview of the debate concerning abolition of laws enabling compulsory mental health treatment versus reform, see P. Gooding, ‘Supported Decision-Making: A Rights Based Disability Concept and Its Implications for Mental Health Law’, Psychiatry, Psychology and Law 20(3) (2013) 431-451; B. McSherry, ‘Mental Health Laws: Where to from Here?’, Monash University Law Review 40(1) (2014) 175-197; B. McSherry and K. Wilson, ‘The concept of capacity in Australian mental health law: Going in the wrong direction?’, International Journal of Law and Psychiatry 40 (2015) 60-69.

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  • 2

    J. Sellin, Access to Medicine, The Interface between Patents and Human Rights. Does One Size Fit All? (Cambridge: Intersentia, 2014) p. 82.

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  • 6

    A. Bruce, Which Entitlements and for Whom? The Convention on the Rights of Persons with Disabilities and its Ideological Antecedents (Lund: Lund University Publications, 2014) p. 160.

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  • 9

    P. Bartlett, ‘The United Nations Convention on the Rights of Person with Disabilities and Mental Health Law’, Modern Law Review 75(5) (2012) 752-778, 753.

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  • 12

    G. Richardson, ‘Mental Capacity in the Shadow of Suicide: What Can the Law Do?’, International Journal of Law in Context 9(1) (2013) 87-105, 92.

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  • 16

    R. Kayess and P. French, ‘Out of darkness into light? Introducing the Convention on the Rights of Persons with Disabilities’, Human Rights Law Review 8(1) (2008) 1-34, 7 (fn. 31).

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  • 18

    Ibid., 318.

  • 22

    Ibid., 319. Dute does not refer to the ‘subjectiveness’ of the concept of dangerous — this attribution has been assigned to the concept by the present authors.

  • 24

    Ibid., 844.

  • 26

    Ibid., 848.

  • 28

    L. Series, ‘Relationships, autonomy and legal capacity: Mental capacity an support paradigms’, International Journal of Law and Psychiatry 40 (2015), 80-91, 89.

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  • 30

    E. Flynn and A. Arstein-Kerslake, ‘Legislating personhood: Realising the right to support in exercising legal capacity’, International Journal of Law in Context 10(1) (2014), 81-104. See also E. Flynn and A. Arstein-Kerslake, ‘The Support Model of Legal Capacity: Fact, Fiction, or Fantasy?’, Berkeley Journal of International Law 32(1) (2014), 124-143, in which the authors set out their views on a ‘plausible’ legal framework for a regime of substituted decision-making which could replace existing regimes of substituted decision-making.

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  • 36

    See, for example, Glor v. Switzerland (European Court of Human Rights, Chamber, Application No 13444/04, 30 April 2009) and, more recently, m.s. v. Croatia (No. 2) (European Court of Human Rights, Chamber, Application No 75450/12, 19 February 2015.

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  • 37

    E. Wicks, ‘The Right to Refuse Medical Treatment under the European Convention on Human Rights’, Medical Law Review 9(1) (2001) 17-40, 22.

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  • 55

    Ibid., 21.

  • 69

    Ibid., 140.

  • 70

    Bartlett, supra note 9, 756.

  • 71

    P. Bartlett, ‘Capacity, Treatment and Human Rights’, Journal of Mental Health Law (2004) 52-65, 57.

  • 72

    Erdmane, supra note 32, 110. Footnote omitted.

  • 76

    Ibid., p. 30; referring to Jehovah’s Witnesses of Moscow v. Russia (European Court of Human Rights, Chamber, Application No 302/02, 10 June 2010) para. 135. Italics inserted.

  • 84

    Hendriks, supra note 75, 39; referring to Jalloh v. Germany (European Court of Human Rights, Grand Chamber, Application No 54810/00, 11 July 2006) para. 70.

  • 85

    Hendriks, ibid., 39. Case law citations omitted.

  • 87

    A point also made by Erdmane, supra note 32, 128.

  • 89

    Wicks, supra note 37, 27.

  • 105

    Erdmane, supra note 32, 122.

  • 120

    Riedel, supra note 111, 183.

  • 122

    Flynn and Arstein-Kerslake, supra note 30.

  • 123

    Ibid., 139-142. The Court declined to consider an Article 14 echr claim in the case of m.s. v. Croatia (No. 2) supra note 36.

  • 124

    Stavert, supra note 27, also notes that the crpd and echr ‘adopt somewhat different approaches to the recognition and exercise of legal capacity’ at 302.

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