§ Mr. Weetchasked the Secretary of State for Social Services under what conditions mentally ill patients are given psychosurgical operations without their fully informed consent.
§ Sir George YoungPsychosurgery is now performed in a very limited number of cases and I am advised that in current practice it is used only after alternative forms of treatment have proved ineffective to treat a seriously incapacitating and chronic condition. It is not normally indicated in psychotic conditions, but published studies have described the relief obtained by some patients with crippling neurotic disabilities.
There is no legal provision authorising or implying that any form of treatment can be imposed on an informal—voluntary—psychiatric patient without his consent. As for any form of treatment, it is established good practice for the doctor to explain to the patient the nature, purpose and likely effects of psychosurgery so that he can give fully informed consent.
As to the 5 per cent, of all in-patients in mental illness hospitals who are detained, the Department's view is that the Mental Health Act gives implicit authority to administer recognised forms of treatment for mental disorder, without the patient's consent where necessary. However, as with informal patients, it is good practice for the doctor to explain any treatment to the detained patient and, wherever possible, to seek his consent. Similarly, it is usual to explain the proposed treatment to close relatives and seek their agreement, although a relative's consent has no 825W standing in law. But I am advised that it is most unlikely that a surgeon would be prepared to perform psychosurgery without the patient's own consent.