Mental Health Bill [HL]

My Lords, it seems to me that the essential point of these amendments is to ensure that when a patient’s past or present wishes about treatment are not respected for whatever reason, the justification for this must be recorded by the decision-maker. This is a modest proposal in terms of legal duties, but I believe that it would have a significant and beneficial effect in the way in which patients’ wishes are addressed by services. It is, thanks to fairly recent case law, a requirement that any second-opinion doctor authorising treatment without consent must justify his or her decision in writing. This amendment would extend that requirement to other decision-makers who may be overriding patient wishes. In my view, and that of the courts, when the matter is brought to their attention, recording reasons is a very basic requirement of responsible and justifiable decision-making, where those decisions may interfere, or potentially interfere, with fundamental human rights. Some exemplary services may already make and record their decisions in such a way that would meet the statutory requirement that this amendment puts forward. Many unfortunately do not. It is on that basis that I support the amendment.