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MCA & suicide - Carers UK Forum

MCA & suicide

For issues specific to caring for someone with mental ill health.
Just considering the MCA and just wondered how it would deal with suicide thoughts. Is it a no-win situation for a carer?

If the person tries to commit suicide and the carer tries to stop them, does that infringe liberties knowing that the caree appears to have mental capacity than an action will likely kill them.

If the carer does nothing, is that neglect ?

Your thoughts ?

Mike.
i feel that no-matter what the law says i would stop my partner.
I do not think the law is strong enough anyway, with Mental Capacity.
For a while, my younger son, when severely depressed, would not have passed the Mental capacity test which my elder son(who has Downs Syndrome), had recently had to pass. Emergency Social Services team refused to test my younger son. (This was a young man whose strongest subject in school was maths, and he wanted to be an accountant, with his depression, he could hardly manage basic maths skills).They had come to our house 24 hours after we had had an emergency situation with our son(they had been "offduty", when the situation had occurred!!!)
The emergency team had advice for me. My son had walked out of our house very agitated, and with a blood sugar of 1. something(almost close to coma,as you will know, Mike). My husband dialled 999, I drove one way to look for him, my daughter drove the other way to find him.The advice from the team,"if he does it again, let him go and the police can pick him up". I asked what would happen if he went into a coma and died before he was found, would I be arrested for neglect, they said don't be silly. Since Rhys died, I asked the police about this potential situation, and they said it could have been a possibility, but they wouldn't like to comment.
I was desperate for help and support, and I knew it needed to be mental health support, but it was not forthcoming at all.
In those circumstances, Lazydaisy, I would have thought that it would not even have been necessary to invoke the MCA, it appears that your son probably met the criteria to be detained under the Mental Health Act. It has long been the case that many people like you find that when they ask for help it is not forthcoming, the laws exist it is their correct application which is lacking.

Interesting question, Mike, there was a fairly recent case where a young woman who had drunk poison prior to the MCA and been treated drew up a living will after the MCA became law and refused treatment, she was allowed to die, the doctors arguing that she had capacity to make that decision, you can read about it here:

http://www.telegraph.co.uk/health/62486 ... sault.html

I have no idea what would happen in the scenario you describe, I am sure most if not all carers would try to save the life of the person attempting suicide, there might be circumstances where a carer felt that the wish to die should be respected, the decision to treat or not based on capacity would then become that of the medical profession.
Maybe the background 'could' be a deciding factor. In the case of a terminally ill person hating every minute of life maybe one answer is right whereas if there's a reasonable chance the person could have a useful and 'enjoyable' future life, it may be more appropriate to make an effort to save them.
That is what I meant when I said that there might be circumstances where the carer felt that the wish to die should be respected, the Purdy case and the recent cases where relatives had accompanied family members to Dignitas in order for them to commit assisted suicide would be cases in point where carers have not only respected the individual's right to commit suicide but have been shown themselves to be willing to, to varying degrees, actively participate in enabling suicide. It is then normally the CPS's decision whether to prosecute, the Purdy case was to ensure that Purdy's husband was not prosecuted should he assist her, but all these cases are ones where mental capacity is not an issue.
Leaving MCA for a moment, I would think the Carer has a legal Duty of Care to try to dissuade the suicidal person, but if it looks like that would fail or Carer believes the situation is too much to handle, then the Carer should inform either the Police or Ambulance, thus passing responsibility onto the Law and by so doing would protect their own legal position, and simultaneously draw the person's plight to medics.

The MCA, in my opinion, was set up to protect everyone, but especially vulnerable people from being exploited or harmed due their incapacity (or inability such as hostage, etc.) to fully understand consequences of their actions and, separately to protect vulnerable people from abuse, usually financial, emotional or psychological (gaslighting). Unless such person has been formally diagnosed as lacking capacity to make particular decision on, say, suicide, they are quite rightly assumed to be sane even if I, or you, might disagree with their decision. Incidentally, even if someone is diagnosed as "incapable to make decision X", they might be "capable to make decision X" at a later date. (So, Carers run for the hill!!!! Image )

Even under the MCA with the person being permitted to make unwise decisions, that person is equally entitled to receive full and open explanations from anyone concerned to aid them to make that decision. (hence I say the Carer should probably TRY). This part of the Act in my experience is being distorted almost to the point of authorities/Social Service etc. almost encouraging (in contrast to aiding with facts) the person to make an unwise decision.

If it's a mental illness emergency situation, then the Mental Health Act should apply, and this would be a Police issue along with the person's GP et al.

In case of terminal illness & Dignitas etc. etc., that's a distinct area well apart from "usual suicide". My personal view is that this should not be called suicide, but a form of planned risk-assessed self euthanasia.

Hope you can understand my ramble here, not sure I do Image Image