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Ethics briefings
  1. Martin Davies,
  2. Sophie Brannan,
  3. Eleanor Chrispin,
  4. Veronica English,
  5. Rebecca Mussell,
  6. Julian C Sheather

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Mental health right to life case

In February 2012, the Supreme Court in England and Wales ruled that the NHS is under a duty to protect the right to life of suicidal psychiatric patients even if they are in hospital voluntarily.1 As previously reported here,2 the courts in England and Wales established in a 2008 case that hospitals and other health organisations owe a duty to patients detained under the Mental Health Act (MHA) to prevent them from taking their own lives. The 2012 case extended this duty so that it applies whether or not a patient has been formally detained.

Having attempted suicide a number of times, Melanie Rabone was admitted to hospital as an informal patient in April 2005. She was assessed as a moderate to high suicide risk and a doctor noted that if she tried or demanded to leave she should be assessed for detention under the MHA. On 19 April, Melanie requested home leave, which was granted; the following day she committed suicide. Her parents brought both a civil negligence claim and a claim for damages for breach of a positive duty to protect Melanie's right to life under article 2 against the Pennine Care NHS Foundation Trust. The Trust had accepted that the decision to allow home leave was negligent and that claim was settled in 2008. Although the article 2 claim for damages had been unsuccessful in both the High Court and Court of Appeal, the Supreme Court ultimately held that an operational duty under article 2 could be owed to a mentally ill hospital patient who had not been detained under the MHA when there was a ‘real and immediate risk’ to life. The court ruled that this operational duty to protect life was owed in Melanie's case and, although she had not been a detained …

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