Scott Starson Case: Mental Illness
Mental illness refers to a disorder having an effect on an individual’s ability to carry out normal routines on a daily basis (Cook, 2007). Often, there have been cases involving mentally ill patients who alleged violation of their rights in regards to their treatment. One such case involved Scott Starson, who claimed that his rights had been violated by Ontario Consent and Capacity Board. The board had decided that Starson was incapable of making his decisions about treatment due to his mental illness. Therefore, his consent decisions regarding treatment were not to be given much of consideration. However, the courts ruled against the decision of the board claiming that it had violated his rights. In upholding the right of Starson, the court violated ethical issues considering what his decision would have caused. The ethical issue, in this case, stems from whether the autonomy of mentally ill patients should be upheld (Adams & Miller, 2001).
According to Wright et al. (2008), the individual rights of mentally ill persons have been championed by courts in this era. However, amid all this, a delicate balance has emerged. Such was a case that pitted the board against an individual who was suffering from mental illness. The board had the mandate of ensuring that patients with mental illness get the necessary assistance that does suit them in terms of medication. Moreover, the board made critical treatment decisions in cases of incapacitation.
The arguments put across by the board were not only rational but also to some extent factual. It was prudent for the board to recognize paternalism in such a case, which the board did. Such recognition of the parents decision is an ethical issue based on social context. Moreover, it is a way of showing empathy and sympathy to the patient’s parents bearing in mind his mental state. The court’s ruling sent a message that close family members could not make the decision for their loved one if at all they disagreed with it due to his or her mental condition. This decision implied that paternalism could not be used to relate to a patient (Burkhardt & Nathaniel, 2002). Moreover, the nursing values of promoting health and well-being were disregarded. The is also the need of promoting and respecting informed decision making in which case the court appeared to ignore (Canadian Nurses’ Association, 2008).
McKenzie (2008) explains that the courts stated that the board had overstepped the concept of best interest in determining Starson’s treatment without his consent. In an equal measure, the same courts did fail to accommodate the interests of Starson’s family, especially his mother who had so wished that his son be treated. Ultimately in this way, the courts shunned diversity and insulted paternalism. The board did at some point argue that as much as an ill individual may be left to make his decision, they can be wrong. Therefore, the ruling of the court seemed to illustrate that even if someone is making an unwise choice it is his or her right. Such decision is fallacious and defies ethics based on paternalism and material beneficence.
The illegitimacy of this decision is because if an individual’s decision is wrong, then the court should allow his or her relatives to decide on their behalf. Kucharska and Hannah (2004) explain that such a decision should be considered as most appropriate and that it is beneficial to the patients unless when it is based on moral vices. Additionally, the values of providing safe and compassionate care are floated by the courts since consideration of Starson’s close relatives was disregarded (Pauly et al., 2009).
The court asserted that the drugs used in the treatment had side effects and could not be proved as being capable of healing the patients. However, such treatment was crucial for contentment of the otherwise, perturbed parents (McKenzie, 2008). The fact that their son was treated was a source of hope and mental peace. Psychologically, this is very beneficial to the members even if they lose their loved as compared to leaving him untreated because it was his decision. Concluding on this subject, the courts failed in trying to arrive at a decision that would serve to be ethical and fair to the parties involved, including the nursing bodies.
Adams, D., & Miller, B. K. (2001). Professionalism in nursing behaviors of nurse practitioners. Journal of Professional Nursing, 17(4), 203-210.
Burkhardt, M.A., & Nathaniel, A.K. (2002). Ethics & issues in contemporary nursing, (2nd ed.). Toronto: Delmar Publishers
Canadian Nurses’ Association. (2008). Code of ethics for registered nurses. Canadian Nurses Association= Association des infirmières et infirmiers du Canada.
Cook, L. J. (2007). Striving to help college students with mental health issues. Journal of psychosocial nursing and mental health services, 45(4), 40-44.
Kucharska, D., & Hannah, R. (2004). Seniors’ Health and Housing Crossroads. Retrieved on July, 5, 2006.
McKenzie I. J. (2008). The Delicate Dance in Canadian Mental Health Policy: Balancing Equality Rights, Family Rights and Community Rights. Journal of Ethics in Mental Health, 3(2), 1-6.
Wright, A. A., Zhang, B., Ray, A., Mack, J. W., Trice, E., Balboni, T., & Prigerson, H. G. (2008). Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. Jama, 300(14), 1665-1673.