The relationship between ethics and law in mental healthcare

Mental healthcare is fraught with ethical challenges. Treatment and care which are genuinely person-centred, evidence-based and founded on respect for the person who is being cared for can effect profound change in the lives of people with mental and psychosocial disabilities. Although both clinical practice and law are underpinned by the principle of doing what is best for the person receiving treatment, the notion of "best interests" is value-laden and contested. It can be argued that in mental healthcare an emphasis on the concept of benefit has obscured the equally salient obligation to avoid harm, a concept which has a role to play in drawing attention to the need for careful deliberation in relation to such "high-stakes" concepts as "best interests", "insight" and "risk", none of which are amenable to univocal interpretation. The aim of this chapter is to draw attention to the role of ethics in mental health practice as it is shaped by the law, particularly in light of the entry into force of the CRPD. Greater reliance on clinical ethics mechanisms and the provision of ethics education may help to streamline clinical and judicial decision-making in this complex area by broadening the scope of the discussion, incorporating multiple perspectives and promoting accountability, fairness and inclusiveness.