King's College London

TY - JOUR

T1 - Isolation of patients in psychiatric hospitals in the context of the COVID-19 pandemic

T2 - An ethical, legal, and practical challenge

AU - Brown, Christian

AU - Ruck Keene, Alex

AU - Hooper, Carwyn Rhys

AU - O'Brien, Aileen

PY - 2020/7/1

Y1 - 2020/7/1

N2 - Psychiatric inpatients are particularly vulnerable to the transmission and effects of COVID-19. As such, healthcare providers should implement measures to prevent its spread within mental health units, including adequate testing, cohorting, and in some cases, the isolation of patients. Respiratory isolation imposes a significant limitation on an individual's right to liberty, and should be accompanied by appropriate legal safeguards. This paper explores the implications of respiratory isolation in English law, considering the applicability of the common law doctrine of necessity, the Mental Capacity Act 2005, the Mental Health Act 1983, and public health legislation. We then interrogate the practicality of currently available approaches by applying them to a series of hypothetical cases. There are currently no ‘neat’ or practicable solutions to the problem of lawfully isolating patients on mental health units, and we discuss the myriad issues with both mental health and public health law approaches to the problem. We conclude by making some suggestions to policymakers.

AB - Psychiatric inpatients are particularly vulnerable to the transmission and effects of COVID-19. As such, healthcare providers should implement measures to prevent its spread within mental health units, including adequate testing, cohorting, and in some cases, the isolation of patients. Respiratory isolation imposes a significant limitation on an individual's right to liberty, and should be accompanied by appropriate legal safeguards. This paper explores the implications of respiratory isolation in English law, considering the applicability of the common law doctrine of necessity, the Mental Capacity Act 2005, the Mental Health Act 1983, and public health legislation. We then interrogate the practicality of currently available approaches by applying them to a series of hypothetical cases. There are currently no ‘neat’ or practicable solutions to the problem of lawfully isolating patients on mental health units, and we discuss the myriad issues with both mental health and public health law approaches to the problem. We conclude by making some suggestions to policymakers.

KW - COVID-19

KW - Isolation

KW - Mental Health Act

KW - Public health law

KW - Seclusion

UR - http://www.scopus.com/inward/record.url?scp=85085310096&partnerID=8YFLogxK

U2 - 10.1016/j.ijlp.2020.101572

DO - 10.1016/j.ijlp.2020.101572

M3 - Article

C2 - 32768110

AN - SCOPUS:85085310096

VL - 71

JO - International Journal of Law and Psychiatry

JF - International Journal of Law and Psychiatry

SN - 0160-2527

M1 - 101572

ER -