Presented by Dr Meg Smith OAM Ph.D FAPS
Everyone. at some stage in life is going to need a substitute decision maker. For most of us, this might be as minor as giving a friend a general power of attorney to manage the household bills while being away on a remote holiday or ensuring there is someone to give consent to medical treatment or to be contacted in an emergency.
At the other end of the spectrum is the total control of health, lifestyle and financial decisions by someone other than you. The old 1958 Mental Health Act is an example. If you were found to be "mentally ill" because you had a "mental illness" then medical decision making was taken away from you and you were automatically put under the Protective Commissioner who then made all your financial decisions for you. Vague definitions led to much abuse. The current Mental Health Act in NSW has an interesting list of what is not a mental illness. This might be hilarious if you didn't know that people were committed under the old 1958 Act as being mentally ill because they did vote for the Communist party or were gay or enjoyed a number of sexual partners.
Since the early 1980s, there have been major changes in legislation affecting people living with disabilities that affect decision making capacity. Guardianship legislation now offers a more flexible process to enable decisions to be made for people when they cannot make decisions for themselves. However there are still some areas of concern for professionals working with people living with a disability. When do the terms "least restrictive", "in a person's best interests" "continuing condition", "incapacity" apply? What is a the difference between a general power of attorney, an enduring power of attorney and a financial management order? What is a "mental illness" and what are the implications for the person? When do people have the right to decide for themselves about voluntary euthanasia, refusing medical treatment or the right to spend their income on alcohol and poker machines?
About Dr Meg Smith OAM Ph.D FAPS
Dr Meg Smith is a community psychologist who has been an advocate in mental health since her own diagnosis of bipolar disorder many years ago. After her own experience as an involuntary patient under the old 1958 Mental Health Act she has been active in legislative reform and professional education in mental health and disability care. Meg has been a lecturer in criminology, social policy and community mental health studies at the University of Western Sydney. Dr Smith is currently a part time member of the Mental Health Review Tribunal and the Guardianship Division of the NCAT and has a private practice at Manly Psychology Centre.