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Advance Directives One way to assert your rights…. Vivienne Topp Policy Coordinator / Lawyer. Charter Rights. All Victorians have the right to:
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Advance Directives One way to assert your rights…. Vivienne Topp Policy Coordinator / Lawyer
Charter Rights • All Victorians have the right to: • Recognition and equality before the law , this includes freedom from discrimination because of having a psychiatric disability and freedom to make decisions.
Section 10 A person must not be— (a) subjected to torture; or (b) treated or punished in a cruel, inhuman or degrading way; or (c) subjected to medical or scientific experimentation or treatment without his or her full, free and informed consent.
Limitations The Charter also says: Those rights can be limited by other Acts/pieces of legislation, by “reasonable limits that can be demonstrably justified in a free and democratic society based on human dignity, equality and freedom , and taking into all relevant factors.” • Section 7(2)
But only when………. Any attempt to limit an individual’s rights must be demonstrably: • reasonable, and • necessary, and • justified, and • proportionate Vic EOCHRC
Standing up for your rights • Without mechanisms to assert these rights , they are hollow………..they are just words
MHLC Advance Directive Project • At a community forum people living with mental illness, family, carers, and mental health professionals identified advance directives (AD’s) as a critically under-utilized human rights tool. • AD’s have the potential to achieve and retain independence, self-determination and non-discrimination for people living with mental illness. ‘Advance Directives’, Hotel Y, June 22nd, 2006.
What are ‘Advance Directives’? • A type of document created by people living with mental illness while they are well • Typically documents contain special information outlining a person’s unique circumstance, personal preferences regarding treatment choices, and information about practical life management arrangements in the event they become unwell • They are not legally enforceable in Victoria
Types of Advance Directive • Instructional • Proxy • Hybrid
What can you put in an Advance Directive? • Treatment preferences • Who to notify / Who not to notify • Arrangements for the care of - children - pets - accommodation - financial matters
What does an Advance Directive look like? http://www.capsadvocacy.org/about scroll down to CAPS and Advocard advance statement form.pdf
What are the Benefits? “Nothing about us without us” • Valuing the consumer in all aspects of their lives • Encourages discussion between parties • Better clinical outcomes
Consumer Experience: • Problems with inappropriate diagnosis • Potential re traumatisation especially under involuntary status: treatments/detention • Underlying issues can remain unattended • Diagnosis….. • Risk of history of ‘bad’ interactions with ‘helping’ professions
Can they make a difference? Women diagnosed with mental illness are often women with a history of childhood trauma, emotional, physical and sexual abuse and/or neglect as well as women living in situations of recurrent male violence Experiences retriggered during acute unit admissions where they again experience violence and fear –
Advance Directives are not Treatment Plans • TP – imbalance in power relations between clinician and consumer • TP are about treatment alone. ~ • AD – consumers frame the content • AD are about treatment and practical measures
Overseas Research Findings • AD Not used to refuse all treatment • People are well-informed about latest treatments • People choose feasible alternatives
The Mental Health Legal Centre Project - Aims • To represent the consumer as an ‘active voice’ in formal research
The Mental Health Legal Centre Project - Aims 2. To understand the difficulties and opportunities faced by consumers, family carers and clinicians in articulating, producing and implementing advance directives
The Mental Health Legal Centre Project - Aims 3. To provide community based resources and information
The Mental Health Legal Centre Project - Aims • To identify law reform necessary to enable legal recognition and respect of advance directives ~ Contact: MHLC 0396294422 Martin_Thomas@clc.net.au or Vivienne _Topp@clc.net.au