The position of the medical profession in regard to certificates of mental unsoundness and civil incapacity / by T.S. Clouston.

  • Clouston, T. S. (Thomas Smith), 1840-1915.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The position of the medical profession in regard to certificates of mental unsoundness and civil incapacity / by T.S. Clouston. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    and worthless. It is quite the exception for me to get a certificate where the patient is designated, except one signed by an old student of mine, who had remembered my drillings on this point. There are two opinions given and certified to in every certificate. One is that the patient is “ a lunatic,” or “ an insane person,” or “an idiot,” or “a person of unsound mind” (and, by the way, those expressions become in this way the statutory definition of legal lunacy); the other is that the patient is “ a proper person to be detained under care and treatment.” Both things should be taken into account by the doctor, each separately and distinctly from the other, before he signs. If we grant that the sheriff can judge of the sufficiency of the facts to prove the first, that of “ un- soundness of mind,” it is quite certain he is not in a position to judge as to second, viz., whether the patient is “a proper person to be detained under care and treatment.” That is a medical question, which a medical man alone can solve, and one in which the law gives him no help whatever. If one is to adopt the method of interpreting the meaning of a document from its contents alone, then the sheriff’s order bears no proof within it that the sheriff has considered the facts in the certificates, or is satisfied with them. It simply says that “ having had produced” to him a petition and certificates, he authorizes the transmission and reception of the patient. I therefore conclude that the sheriff does not act judicially in granting orders for the reception of patients into asylums. He is merely bound to see that a petition, statement, and medical cer- tificates are there in due form, and accurately filled in. His position ought to be defined in the next bill we have. I do not think he is properly qualified to say whether the “ facts indicating insanity ” do indicate it or not, that being a medical question, just as is the question of suitability for care and treatment. But what is the good of the sheriff’s order in that case ? It is “ a mere farce,” say some of our English brethren, “pretending to be what it is not, and taking the proper responsibility off the petitioner and medical men.” I dissent from this very emphatically. I look on the pro- vision for inserting “facts indicating insanity” as one affecting the doctor, to compel him to formulate the grounds for his opinion, and not one with which the sheriff has judicial concern. Before the present Scotch Act came into operation the medical certificates contained no “facts;” and yet, on the medical opinion that the patients were insane and should be admitted into asylums, the sheriffs granted orders for that purpose. No “facts” are required in the medical certificates for a man being deprived of the control of his property and a curator bonis appointed for him by a Lord of Session, and no “facts” are stated when the Secretary of State respites a man from the death sentence on account of insanity. The sheriff’s order is most important, apart from its being a judicial decision as to the insanity of the patient. It secures that