Mental Health Act 2025

Prospective

13 Medicine etc: treatment conflicting with a decision by or on behalf of a patient U.K.

(1) The Mental Health Act 1983 is amended as follows.

(2) After section 57 insert—

“57A Treatment without consent requiring a second opinion and a compelling reason

(1) This section applies to the forms of medical treatment for relevant disorder mentioned in subsection (2) where—

(a) the patient has capacity to consent to the treatment but has not consented to it, or

(b) the patient lacks capacity to consent to the treatment, and the giving of the treatment would conflict with—

(i) a valid and applicable advance decision, or

(ii) a decision of a donee or deputy or the Court of Protection.

(2) The forms of medical treatment referred to in subsection (1) are—

(a) such forms of treatment as may be specified in regulations made under section 58(1)(a);

(b) the administration of medicine to a patient by any means (not being a form of treatment specified under section 57, section 58(1)(a) or section 58A(1)(b)) at any time during a period for which the patient is liable to be detained as a patient to whom this Part of this Act applies.

(3) Where this section applies, and subject to section 62, a patient may not be given any of those forms of medical treatment unless there is a compelling reason to give treatment of that form and a second opinion appointed doctor has certified in writing—

(a) that the treatment constitutes appropriate medical treatment,

(b) that the decision to give the treatment was made by the approved clinician in charge of the treatment in accordance with section 56A, and

(c) that, in relation to the form of treatment and any alternative forms of appropriate medical treatment that are available for the patient’s relevant disorder (taking each form of treatment separately)—

(i) the patient has capacity to consent but has not consented, or

(ii) the patient lacks capacity to consent and it appears to the second opinion appointed doctor that there is a decision mentioned in subsection (1)(b)(i) or (ii) which, if valid, would conflict with the giving of the treatment.

(4) For the purposes of this section there is a “compelling reason” to give a form of medical treatment to a patient if—

(a) alternative forms of appropriate medical treatment are available for the patient’s relevant disorder but, in relation to each of those forms—

(i) the patient has not consented, or

(ii) the patient lacks capacity to consent and the giving of the treatment would conflict with a decision mentioned in subsection (1)(b)(i) or (ii), or

(b) no alternative forms of appropriate medical treatment are available for the patient’s relevant disorder.

(5) Before giving a certificate under subsection (3) the second opinion appointed doctor must consult two other persons who have been professionally concerned with the patient’s medical treatment but, of those persons—

(a) one must be a nurse and the other must be neither a nurse nor a registered medical practitioner, and

(b) neither may be the responsible clinician or the approved clinician in charge of the treatment in question.”

(3) In section 58 (treatment requiring consent or a second opinion)—

(a) before subsection (1) insert—

“(A1) This section applies to the forms of medical treatment for relevant disorder mentioned in subsection (1) where—

(a) the patient has capacity to consent to the treatment and has consented to it, or

(b) the patient lacks capacity to consent to the treatment and the giving of the treatment would not conflict with—

(i) any valid and applicable advance decision, or

(ii) any decision of a donee or deputy or the Court of Protection.”;

(b) in subsection (1), for the words before paragraph (a) substitute “The forms of medical treatment referred to in subsection (A1) are—”;

(c) in subsection (3)(b) omit “or being so capable has not consented to it”.

(4) In section 59 (plans of treatment), after “57” insert “, 57A”.

(5) In section 60 (withdrawal of consent), in subsection (1C)(a), after “section” insert “57A,”.

(6) In section 62 (urgent treatment), in subsection (2), after “57” insert “, 57A”.

(7) In section 63 (treatment not requiring consent), for the words from “not”, in the second place it occurs, to “applies” substitute “where none of sections 57 to 58A apply”.

(8) In section 64C (section 64B: supplemental)—

(a) for subsection (3) substitute—

“(3) Relevant treatment is—

(a) section 58 type treatment if it is—

(i) treatment of a form which, at the time when it is given to the patient, is specified under section 58(1)(a), or

(ii) the administration of medicine to the patient by any means (not being a form of treatment specified under section 57, section 58(1)(a) or section 58A(1)(b)) if a period equal to or longer than the section 58 period has elapsed since the first occasion, during the relevant period, when medicine was administered to the patient by any means for relevant disorder;

(b) section 58A type treatment if it is—

(i) electro-convulsive therapy, or

(ii) treatment of a form which, at the time when it is given to the patient, is specified under section 58A(1)(b).

(3A) For the purposes of subsection (3)—

(a) the “section 58 period” is the period which, at the time when the treatment is given to the patient, is specified under section 58(1)(b);

(b) the “relevant period” is the period during which the patient has continuously been a patient to whom this Part applies.”;

(b) in subsection (6), for “subsection (1)(a) of that section” substitute “subsection (3)(b)(i) of this section”;

(c) in subsection (7)—

(i) for “subsection (1)(b) of that section” substitute “subsection (3)(b)(ii) of this section”;

(ii) for “that section”, in the second place it occurs, substitute “section 58A(1)(b)”.

Commencement Information

I1 S. 13 not in force at Royal Assent, see s. 56(3)