Consent Issues in Anaesthesia - Australian And New Zealand 在麻醉的澳大利亚和新西兰的同意的问题.pptVIP

CHILD ABUSE AND NEGLECTReporting and disclosure Mental Health Law Conference1 November 2012 Peter Le Cren Special Counsel Claro Case Study 1: A patient with long history of depressive episodes; has been admitted under the MHA, though not under the Act at present. Father of 2 preschool children; shared day to day care with ex partner. He discloses to his psychiatrist thoughts about killing himself and his children. Does the psychiatrist disclose to Child, Youth and Family Services? Case Studies: Case Study 2: Patient with chronic schizophrenia. Under s.29 MHA due to history of poor medication compliance leading to disorganisation and self neglect. Key worker sees children in the patient’s home and becomes aware?that she is working for a child care organisation. The patient refuses consent for the key worker to speak with the organisation. Does the key worker disclose to the child care organisation? To CYFS? Case Studies: Case Study 3: Patient with a long history of mental illness, presently admitted to an inpatient unit under s.29(3) MHA due to acute relapse. The patient is the mother of a primary school age child. The school are concerned about the child’s wellbeing and refer to CYFS. CYFS request a copy of the mother’s medical records. Should the records be provided to CYFS? Case Studies: 4-10% of NZ children experience physical abuse 24% of girls and 11% of boys experience sexual abuse Child physical abuse increases: - mental health problems by 2-4 times - suicide attempts by 4 times - alcohol abuse by 2 times - impaired relationships by 4 times. The attributes that create vulnerability to abuse and neglect include, amongst many others, maternal or paternal mental health disorders - particularly bipolar affective disorder, persistent depression, alcohol and substance abuse, and personality disorder. Goodwin, Fergusson and Hallwood (2004), Psychological Medicine Fergusson, Hallwood and Linsky (1996), Journal of the American A