TY - JOUR T1 - Current appeal system for those detained in England and Wales under the Mental Health Act needs reform JF - Journal of Medical Ethics JO - J Med Ethics DO - 10.1136/medethics-2018-104947 SP - medethics-2018-104947 AU - Paul Gosney AU - Paul Lomax AU - Carwyn Hooper AU - Aileen O’Brien Y1 - 2018/12/04 UR - http://jme.bmj.com/content/early/2018/12/04/medethics-2018-104947.abstract N2 - The approach to managing the involuntary detention of people suffering from psychiatric conditions can be divided into those with clinicians at the forefront of decision-making and those who rely heavily on the judiciary. The system in England and Wales takes a clinical approach where doctors have widespread powers to detain and treat patients involuntarily. A protection in this system is the right of the individual to challenge a decision to deprive them of their liberty or treat them against their will. This protection is provided by the First-tier Tribunal; however, the number of successful appeals is low. In this paper, the system of appeal in England and Wales is outlined. This is followed by a discussion of why so few patients successfully appeal their detention with the conclusion that the current system is flawed. A number of recommendations about how the system might be reformed are offered. ER -