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On Medical Certificates of Insanity
Published online by Cambridge University Press: 19 February 2018
Extract
The liberty of the subject, so dear to all Englishmen, is under certain conditions placed by the law of the land at the discretion of any two qualified medical men. That the confidence thus reposed in the members of our profession has not been abused is proved by the evidence of an unimpeachable witness, namely, that of the Earl of Shaftesbury, who, as Chairman of the Commissioners in Lunacy, asserted before the special Parliamentary Committee, that in his experience of nearly thirty years “there has not been more than one or two cases in which any person has been shut up (that is, in a lunatic asylum) without some plausible ground for his or her temporary confinement; but in every instance, with these exceptions, there have been certain plausible grounds in fact or in logic, sufficient to justify the temporary confinement of the persons, and their being submitted to medical treatment.” It is highly creditable to our profession, that a man of Lord Shaftesbury's position and experience should be able to give this strong and definite testimony, to the manner in which the statutory powers of medical men in giving certificates of insanity have been exercised; but at the present time it is not my desire to dwell upon the sound judgment and honest intention with which this great social responsibility has been discharged, but to direct the attention of the meeting to the abundant and constantly recurring errors of form, which are committed in filling up medical certificates, in the hope of affording such few hints as my experience may suggest, by which they may be avoided. So abundant are these errors, that I hear medical gentlemen connected with private Lunatic Asylums assert that it is the exception, and not the rule, to receive with a patient, admission-papers which require no amendment. Indeed, a physician in charge of a first rate private asylum assures me, that he has never yet received admission-papers which did not need amendment. This is a matter of great importance, for (to say nothing of the delay and expense incurred in procuring these amendments, which are so great that the proprietor of a large private asylum assures me, that he invariably prefers the expense of procuring altogether new certificates) any errors or omissions, not discovered and rectified, would leave the proprietor of an asylum liable to heavy damages, under an action for false imprisonment. The courts of law very properly require that these medical documents, under which men are deprived of their liberty, shall be drawn up in exact accordance with the provisions of the statute. An early illustration of this principle was afforded by the decision of Mr. Justice Coleridge, in the case of Mr. Greenwood, in which he declared that the medical certificates were invalid, and that the patient had been improperly confined, because the name of the street, and the number of the house, in which the medical examination had taken place, were not stated upon the certificate. The formal part of the certificate is indeed a very simple one, and contains no one thing which might be omitted.
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