Mental Health Tribunal vs Community Treatment Order (WCH v Mental Health Tribunal (Human Rights) (Amended)

Health Law and Ethics Name Institution Health Law and Ethics Summary In the case (WCH v Mental Health Tribunal (Human Rights) (Amended) [2016] VCAT 199), the VCAT was requested to reflect on a community treatment order (CTO) of the Mental Health Tribunal (MHT) be annulled due to the compulsory disease management criteria established in the Mental Health Act 2014 were not met. The principle of this specific act mirrors the move to the delivery of mental health services that

Running Head: HEALTH LAW AND ETHICS
Health Law and Ethics
Name
Institution

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Health Law and Ethics
Summary
In the case (WCH v Mental Health Tribunal (Human Rights) (Amended) [2016] VCAT
199), the VCAT was requested to reflect on a community treatment order (CTO) of the Mental
Health Tribunal (MHT) be annulled due to the compulsory disease management criteria
established in the Mental Health Act 2014 were not met. Significantly, WCH presented in the
case that the CTO had violated the rights of the citizens and breached the citizen’s rights as
provided in the Charter of Human Rights. Consequently, WCH had been detected with mental
disorder in 1993 where he was attended using CTO in the past sixteen years (Christopher &
Callaghan, 2017). WCH did not consider that had the disorder and Tribunal established the fact
that client had no mental disorder under MH Act plus ordered that CTOs should be cancelled as
this was in line with defendant’s rights as provided in provisions of human rights.
Autonomy
The respect for autonomy is a standard of respecting, as well as encouraging independent
choices, by instituting the need to respect the capability of an individual to independent choices.
This implies that autonomous actions must be subjected to controlling restraints by other
individuals. Under the ethical perspective, patients that have the capacity to make decisions
should be allowed to do so and not subjected to compulsory treatment methods or therapies.
Subjecting an individual to mandatory treatments will be infringing the autonomy to make
decisions. The element of autonomy is evident in the case where WCH should be given the
autonomy to make decisions regarding the mode of treatment that he needs rather than subject

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him to a treatment that seems to violate his autonomy in making treatment decisions (Ingram,
Muirhead & Harvey, 2009). Particularly, VCAT was needed to ascertain whether WCH had a
mental disease and whether, because WHC had mental disease, he required immediate treatment
to stop severe worsening in his mental wellbeing and to an extent the physical health or severe
harm or another individual under the MH Act. The principle of this specific act mirrors the move
to the delivery of mental health services that focus on autonomy, in which an individual
receiving care has the right to make own choices regarding the kind of treatment. However,
based on ethics, WCH should be given a chance to make decisions concerning his state of health
because he has the autonomy to make informed decisions and must not be forced by the tribunal.
The current compulsory treatment order appears to infringe on the autonomy of WCH as it
violates his autonomy of thinking, as well as rights as an Australian resident. Thus, WCH should
be given the autonomy to make decisions concerning his treatment methods rather than the
current compulsory treatment orders (Beauchamp & Childress, 2019).
In this case, WCH has not been shown to lack the capability to undertake decisions
regarding his mode of treatment and should be allowed to make choices, which would advantage
him. Based on the utilitarianism, the patient should be given a chance to make decisions that will
make him happier other than subjecting him to community treatment orders that will further
harm his current mental illness. WCH should be permitted to undertake decisions concerning his
treatment, which will promote autonomy and will own the decisions he has made (Peele &
Chodoff, 2009).
The Principle of Beneficence and Non-Maleficence

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Beneficence is founded on the standard the good of another person should be promoted
by others, where these individuals have the moral responsibility to act for other persons’
advantage by assisting them to boost their significant plus justifiable concerns. This is clearly
shown in utilitarianism where an act should promote the greater happiness of other people rather
than that of the minority. The main premise for non-maleficence is non-negotiable since it
prohibits subjecting harm to other people. In the case, CTO is seen as attempting to impose
treatment to a patient that he does not require, which goes against the standard of beneficence
along with non- maleficence (Singer, 2015). The patient should be allowed to choose the
preferred treatment to promote the good of the patient and not impose a CTO that infringes on
the rights of the patient. WCH wanted to be given a chance to choose therapy as an intervention
to manage his mental illness. The continued use of CTO on the patient as compulsory treatment
will likely cause harm to the client who believes that therapies could cure the depression he
believes he is suffering from. Therefore, CTO will continue to cause avoidable harm to WCH
where CTO may be considered to be unsuitable to his current mental illness (Burns & Dawson,
2009). CTO is not in the interest of the patient has WCH is dissatisfied with it and believes that
the use of alternative therapies would cause more good to his health. Consequently, it appears
that CTO violates the principles of non-malfeasance towards promoting the good of the patient
with mental illness. On the other hand, CTO is seen to promote the principle of beneficence,
where the treatment has been taken as mandatory rather than a choice for the good of the patient,
that is, WCH. Therefore, beneficence principles support CTO as a way of promoting the
favourable welfare of the patient to lower avoidable suffering (Fletcher, 2016).
Principle of Justice

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The rule of justice may be described as the ethical obligation to act based on fair
settlement amid competing assertions. In the case of WCH, it is apparent that the competing
claims were to promote CTO as community intervention and meeting the individual needs of the
patient. In offering CTO to the patient the rights of WCH should be respected to guarantee
justice and making sure that the legal rights of the client should be respected (Adler, 2012).
Conclusion
A community treatment order appears to infringe on the rights of the patient and it is
likely to undermine the autonomy of the patient is seeking appropriate care. WCH was opposed
to CTO and preferred the use of alternative therapies to manage his mental illness. Therefore,
CTO violated the autonomy of the patient to make informed decisions regarding the method of
treatment that he needed.

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References
Adler, M. D. (2012). Well-Being and Fair Distribution: Beyond Cost-Benefit Analysis. New
York: Oxford University Press.
Beauchamp, T. L. & Childress, J.F. (2019). Principles of Biomedical Ethics, 8th edition, New
York: Oxford University Press.
Burns, T, & Dawson, J. (2009). Community treatment orders: how ethical without experimental
evidence? Psychol Med. 39(2), 1583-1586.
Christopher J.R. & Callaghan, S. (2017). The Impact on Clinical Practice of the 2015 Reforms to
the NSW Mental Health Act. Australasian Psychiatry. 25(1), 43-47.
Fletcher, G. (2016). The Philosophy of Well-being: An Introduction, London: Routledge.
Ingram, G., Muirhead, D & Harvey, C. (2009). Effectiveness of community treatment orders for
treatment of schizophrenia with oral or depot antipsychotic medication: changes in
problem behaviours and social functioning. Aust N Z J Psychiatry. 43(2), 1077-1083.
Peele, R & Chodoff, P. (2009). Involuntary hospitalization and deinstitutionalization. In: Bloch
S, Green SA, eds. Psychiatric ethics. 4th ed. New York: Oxford University Press; pp.
211-228.
Singer, P. (2015). The Most Good You Can Do: How Effective Altruism is Changing Ideas about
Living Ethically, New Haven: Yale University Press.