Saturday, 6 June 2015

My Encounter With The Most Illiberal, Nannying Act On The Statute Book

While I am not a fully sold-out libertarian, I do have leanings that way. And one of them is that people have to take responsibility for their actions. Call me a Victorian Thatcherite, but I believe that this country has gone downhill because people no longer take responsibility, but instead think that everything that is self-inflicted is the fault of an individual called Someone Else.

This is such a peculiar stance to take that the NHS assumes anyone holding this view must be mentally ill and needs nanny to step in.

On Tuesday I was on my way in to work by train and I was starting to get strong chest pains and feeling dizzy. Now, anyone who knows me knows that this happens, and I have to make a judgment call on whether to seek help (as I do if it feels different to normal) or carry on. This time I decided to seek help so got off the train at the next stop, spoke to a member of the platform staff, who got a first aider. First aider called 999, first responder came, and an ambulance followed.

This is fairly routine. My blood pressure was very high - 205/135 - and I was asked by the paramedics whether I had taken my tablets for this. I explained that I had been disorganised and had not got round to sending off my repeat prescription. The tests in the ambulance - the ECG and blood pressure test - simply showed that the only problem was my blood pressure being so high.

So, when we got to A&E I had made the decision not to go in:

  • My being ill that day was self-inflicted. While not intentionally, it was still self-inflicted as I could have taken the steps not to have such high blood pressure but had not done so
  • We had established the cause - the NHS's resources are limited and I am not willing for NHS time and NHS money to be spent on unnecessary tests on me
  • I could go home, phone my GP surgery, get a "sit and wait" appointment that afternoon, and have new sets of tablets by the evening

I explained this, and started to leave, when the paramedics blocked me and started pushing me to towards the A&E entrance, while I was protesting that I wanted to leave. Then another healthcare worker came out, and he joined them in blocking me and pushing me. When he heard why I did not want to go in, he did something that shocked me and sums up the nanny state.

Because I was refusing to go in, he diagnosed me as lacking "capacity" under the Mental Capacity Act 2005.

I was reaching my shirt pocket to get my mobile, deciding I was going to phone the police. Even if diagnosing me as lacking "capacity" now gave them huge legal powers over my body, these powers did not apply prior to that point. As far as I was concerned this was both false imprisonment and assault.

So, why didn't I phone the police? It's because it would have taken them several minutes to get there, and I had a feeling that the healthcare worker was looking for a reason to section me. So, if the police were to find a healthcare worker and a couple of paramedics detaining someone who has been sectioned, who would they listen to? Precisely.

After I was forced in, I had to sit down and another blood pressure test was done against my wishes, and then taken to a side room. The healthcare worker told me he was going to do an ECG and ordered me to take my shirt off for that. He then left to get the ECG machine, and a few minutes later came back to find me sitting there, still shirted. I informed him that I did not trust him - he had been constantly speaking to me as if I were retarded, he had physically bullied me, he had abused his position, he was acting with no respect for my wishes and showing me no dignity - and walked out. A nurse outside the door asked me if I could allow him to do the ECG instead, but I said no, and that I just wanted to get away from that healthcare worker.

I was walking out, the nurse asking me to stop, and the healthcare worker behind him. Near the exit of A&E, as I passed the security guard, I pointed out the healthcare worker to the security guard and asked him to keep that man away from me. After I left the nurse followed and asked me to come back, but I kept walking and got the next train home.

When I got home, I made a doctor's appointment. My GP was quite surprised at all this, and mentioned that on my notes it is emphasised that I don't like needles - of course, if I had stayed, then there is no doubt that a blood test would have been forced on me against my will. He changed my prescription slightly, and so I got new tablets. End of.

It could all have been avoided if I had been better organised.

The whole experience is quite concerning.

The European Court of Human Rights has a guide to Article 5 of the European Convention on Human Rights.

Now, the Convention guide is clear that detention of "a person of unsound mind" (as I now legally was, having been diagnosed as lacking "capacity") is acceptable in certain circumstances:

An individual cannot be deprived of his liberty as being of “unsound mind” unless the following three minimum conditions are satisfied....

  • the individual must be reliably shown, by objective medical expertise, to be of unsound mind, unless emergency detention is required;
  • the individual’s mental disorder must be of a kind to warrant compulsory confinement. The deprivation of liberty must be shown to have been necessary in the circumstances;
  • the mental disorder, verified by objective medical evidence, must persist throughout the period of detention.

This is followed by:

No deprivation of liberty of a person considered to be of unsound mind may be deemed in conformity with Article 5§1(e) of the Convention if it has been ordered without seeking the opinion of a medical expert

It is hard to see how my belief in self-responsibility was a serious enough mental disorder for these exemptions on Article 5 to apply.

The ironically-named NHS Choices site, with its laughable tagline of "Your health, your choices", asks "Do I have the right to refuse treatment?", with the emphasis that:

Under the terms of the Mental Capacity Act 2005, all adults are presumed to have sufficient capacity to decide on their own medical treatment, unless there is significant evidence to suggest otherwise.

The link states:

If someone makes a decision about treatment that other people would consider to be irrational, it does not necessarily mean they have a lack of capacity, as long as they understand the reality of their situation. For example, a person who refuses to have a blood transfusion because it is against their religious beliefs would not be thought to lack capacity. They still understand the reality of their situation and the consequences of their actions.

The Social Care Institute for Excellence website notes that the principles of the Act include:

Adults at risk have the right to make decisions that others might regard as being unwise or eccentric and a person cannot be treated as lacking capacity for these reasons. (emphasis mine)

The healthcare worker might indeed believe that my decision was irrational. but he was wrong to treat this as meaning I lacked "capacity".

For that reason - and the fact he was acting in violation of Article 5 when he diagnosed me - I do not accept his diagnosis as having any legal, medical or moral validity.

The experience is deeply worrying, as it seems that if you refuse medical tests then it doesn't matter what the reason is - you will automatically be diagnosed as lacking "capacity" giving medical persons the right to carry them out.

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