The Legal Problem of Medical Consent and Acquittal and Its Negative Impact on the Violation of the Rights of Patients with Mental Disorder
akhlāq-i pizishkī i.e., Medical Ethics,
Vol. 18 (1403),
29 July 2024
,
Page 1-15
https://doi.org/10.22037/mej.v18i-.45181
Abstract
Background and Aim: Awareness of the therapist's interventions includes informing the patient of the nature of the medical decision, treatment methods, the risks and benefits of the proposed treatment and the possible side effects of each treatment method. Failure to understand these elements distorts the consent and acquittal obtained from the patient; it is considered a violation of medical ethics and causes civil and criminal liability for the therapist. In medical emergencies, it is either impossible or difficult and time-consuming to inform the patient or his/her legal representative of the complications and risks of treatment, necessitating the modification of the legal standards of emergency medical interventions in Iranian health law, especially in the case of patients with mental disorders.
Methods: The present study is a narrative review with a Critical Legal Studies (CLS) approach. To this purpose, relevant books and articles were extracted using Farsi databases such as SID and Magiran and international databases including Science Direct, PubMed, and Google Scholar motor engine. The search was conducted without the limitation of until June 2024, using the keywords criminal law, EMS, mental disorders, patient rights, victimization. The present study is conducted after reviewing 25 references out of a total of 61 Farsi and English books and articles, focusing on presenting a critical legal analysis and not limited to reviewing the mentioned studies.
Ethical Considerations: Throughout all the stages of conducting this research, authenticity of sources, honesty and integrity have been observed.
Results: The "Executive Regulations on the Maintenance and Treatment of Individuals with Mental Health Conditions" (approved in 2019) and the "Bill for the Protection of the Rights of Individuals with Mental Disorders" (drafted in 2020) have not addressed issues related to healthcare providers’ consent and acquittal of the patients, as outlined in the Islamic Penal Code and the Criminal Procedure Code. The challenge of criminality/victimization of patients with mental disorders during the transfer to the emergency department is still not adequately regulated.
Conclusion: The regulations governing the practice of medical professions and related occupations do not adhere to a coordinated and consistent criminal policy, especially regarding the conditions, scope, legal enforcement guarantees for medical acquittal and consent. Between article 492 of the Islamic Penal Code (approved in 2013) and Note 1 of Article 496 of the same Code contain contradictions regarding the nature of medical consent and acquittal, the related legal burden of proof and the concurrence of causation and agency in cases of medical malpractice (involving the physician and other members of the medical staff). Furthermore, it is necessary to amend the Bill of Rights of Individuals with Mental Disorders, before it is approved by the Islamic Consultative Assembly (Iranian Parliament), especially regarding the need to clarify the provisions of this bill concerning hospitalization orders for patients with psychological disorders. It is also essential to determine the duration and manner of its implementation, since it has been overlooked by the legislator thus far.
- Criminal Law
- EMS
- Patient Rights
- Victimization
How to Cite
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