D Lyons
Journal Issue: 
Volume 43: Issue 1: 2013



This review is based in part on a presentation given by Dr Lyons at the RCPE Symposium on The Confused Patient in the Acute Hospital on 7 September 2012.


Treating the confused patient in a general hospital presents legal and ethical challenges for clinicians. The Mental Welfare Commission for Scotland, as a safeguarding organisation, has developed a body of knowledge and guidance on these matters. This paper summarises some of the advice and guidance we have given and directs clinicians to other relevant documents. Visits to patients receiving treatment in general hospitals have shown that clinicians do not always assess capacity or adhere to the law on consent to treatment. Patients may be unlawfully deprived of liberty because of inappropriate or unlawful restraint. As a result, patients’ human rights may be infringed and clinicians may risk legal challenges to their actions. By following best practice in assessing capacity, providing treatment and using restraint ethically, clinicians can avoid these problems. The Mental Welfare Commission welcomes requests for advice in difficult cases.

Keywords Incapacity, mental health, legal, ethical, capacity, consent

Declaration of Interests No conflicts of interest declared.