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| Page 8, line 33 [Clause 12], before ‘person’, insert ‘responsible clinician (if there is |
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| Page 8, line 35 [Clause 12], leave out from ‘(3),’ to end of line 37 and insert ‘for the |
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| words from “, and of those persons” to the end substitute “but, of those persons— |
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| | (a) | one shall be a nurse and the other shall be neither a nurse nor a |
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| | registered medical practitioner; and |
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| | (b) | neither shall be the responsible clinician (if there is one) or the |
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| | person in charge of the treatment in question.”’. |
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| Page 8, line 44 [Clause 12], before ‘approved’, insert ‘responsible clinician or the’. |
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| Page 9, line 1 [Clause 12], leave out from ‘(4),’ to end of line 3 and insert ‘for the |
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| words from “, and of those persons” to the end substitute “but, of those persons— |
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| | (a) | one shall be a nurse and the other shall be neither a nurse nor a |
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| | registered medical practitioner; and |
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| | (b) | neither shall be the responsible clinician or the approved |
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| | clinician in charge of the treatment in question.”’. |
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| Page 9, line 38 [Clause 13], at end insert— |
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| | ‘(3) | In section 72 (powers of tribunals) after subsection (1) insert— |
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| | “(1A) | In determining whether they are not satisfied that a patient is suffering |
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| | from mental disorder of the requisite nature or degree for the purposes of |
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| | subsections (1)(a)(i), (1)(b)(i), (1)(c)(i) or (4)(a) a tribunal must hear |
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| | evidence from a registered medical practitioner approved for the |
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| | purposes of section 12 of this Act or, in an appropriate case, from a |
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| | chartered clinical psychologist.”.’. |
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| Page 14, line 23 [Clause 22], at end insert— |
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| | ‘(c) | an approved clinician shall not make a report for the purposes of renewal |
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| | of detention under section 20’. |
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| Page 17, line 32 [Clause 27], after ‘being’, insert ‘the responsible clinician (if there |
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| Page 18, line 4 [Clause 27], leave out from ‘treatment’ to end of line 7 and insert |
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| | (a) | one shall be a nurse and the other shall be neither a nurse nor a |
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| | registered medical practitioner; and |
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| | (b) | neither shall be the responsible clinician (if there is one) or the |
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| | approved clinician in charge of the treatment in question.’. |
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| Page 27, line 19 [Clause 32], leave out ‘approved clinician’ and insert ‘responsible |
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| clinician or the person’. |
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| Page 28, line 7 [Clause 32], leave out ‘approved clinician in charge of the |
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| treatment’ and insert ‘person in charge of the treatment and an approved clinician’. |
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| Page 29, line 24 [Clause 32], leave out ‘approved clinician in charge of the |
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| treatment’ and insert ‘person in charge of the treatment and an approved clinician’. |
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| Page 30, line 21 [Clause 32], after ‘clinician’, insert ‘or the person in charge of the |
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| Page 30, line 34 [Clause 32], leave out ‘approved clinician’ and insert ‘person’. |
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| Page 30, line 38 [Clause 32], leave out ‘approved clinician’ and insert ‘person’. |
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| Page 33, line 44 [Clause 34], leave out ‘16’ and insert ‘18’. |
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| Page 38, line 22 [Clause 40], at end insert— |
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| | ‘(2A) | Subsections (3) and (4) below shall also apply in the case of a patient who has not |
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| | attained the age of 16 years who is competent to consent to the making of the |
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| | arrangements set out in subsection (1) above.’. |
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| New Clauses and amendments relating to supervised community |
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| treatment; amendments relating to part 2 (other than those relating to |
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| | Authority to treat community patients |
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| To move the following Clause:— |
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| | ‘(1) | The 1983 Act is amended as follows. |
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| | (2) | In section 58(3), after first “patient”, insert “who is liable to be detained under this |
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| | (3) | After section 58 of the 1983 Act, insert— |
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| | “58A | Consent to treatment of community patients |
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| | (1) | Subject to section 62A below, a community patient who has not been |
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| | recalled to hospital shall not be given any form of treatment to which this |
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| | (a) | he has consented to that treatment and either the approved |
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| | clinician in charge of that treatment or a registered medical |
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| | practitioner appointed for the purposes of this Part of this Act has |
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| | certified in writing that the patient is capable of understanding its |
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| | nature, purpose and likely effect and has consented to it; or |
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| | (b) | a registered medical practitioner appointed as aforesaid (not |
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| | being the approved clinician in charge of the treatment in |
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| | question) has certified in writing that— |
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| | (i) | the patient is not capable of understanding the nature, |
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| | purpose or likely effects of that treatment; and |
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| | (ii) | he has either no reason to believe that the patient objects |
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| | to being given the treatment, or he does have reason to |
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| | believe that patient so objects, but it is not necessary to |
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| | use force against the patient in order to give the |
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| | (iii) | he is satisfied that the treatment does not conflict with a |
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| | valid and applicable advance decision, or a decision |
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| | made by a donee or deputy or the Court of Protection; |
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| | (iv) | it is appropriate for the treatment to be given. |
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| | (2) | Where a patient who has been liable to detention under this Act has been |
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| | administered medication for mental disorder to which this section applies |
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| | for less than three months prior to becoming a community patient, the |
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| | period mentioned in section 58(1)(b) above shall be read to extend for no |
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| | longer than one month beginning with the day on which the community |
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| | (3) | The Secretary of State may by order vary the length of the period |
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| | mentioned in subsection (2). |
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| | (4) | Certification under subsection (1)(b) above may take place whilst a |
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| | patient remains liable to be detained, but will not come into force until |
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| | the responsible clinician discharges the patient from detention in hospital |
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| | under the terms of section 17A(1) above. |
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| | (5) | Before giving a certificate under section 58(3A)(b) above the registered |
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| | medical practitioner shall consult two other persons, who have been |
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| | professionally concerned with the patient’s treatment, but of those |
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| | (a) | at least one shall be a person who is not a registered medical |
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| | (b) | neither shall be the patient’s responsible clinician or the |
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| | approved clinician in charge of the treatment in question. |
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| | (6) | In section 61(1), leave out “or “58(3)(b)” ” and insert “58(3)(b), or |
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| | (7) | In section 61(1)(a) after “20(3)”, insert “20A(4)”. |
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| | (8) | In section 61(3) for “responsible medical officer” substitute “approved |
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| | clinician in charge of the treatment in questions”. |
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| | (9) | In section 61(3), leave out “or “58(3)(b)” ” and insert “58(3)(b), or |
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| | (4) | After section 62(2) insert— |
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| | “(2A) | Section 62A below shall not preclude the continuation of any treatment |
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| | or of treatment under any plan pending compliance with section 58 above |
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| | where a community patient is recalled to hospital or a community |
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| | treatment order is revoked and |
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| | (a) | the patient is capable of understanding the nature, purpose and |
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| | likely effect of that treatment and has consented to it; or |
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| | (b) | the patient is not capable of understanding its nature, purpose and |
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| | likely effect of that treatment, but it is not necessary to restrain |
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| | the patient in order to give the treatment.”. |
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| | (5) | After section 62 (Urgent Treatment) insert— |
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| | “62A | Treatment on recall of community patient or revocation or order |
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| | (1) | This section applies where— |
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| | (a) | a community patient is recalled to hospital under section 17E |
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| | (b) | a patient is liable to be detained under this Act following the |
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| | revocation of a community treatment order under section 17F |
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| | (2) | Subject to section 62 above, a patient to whom this section applies shall |
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| | not be given any form of treatment to which section 58 applies without |
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| | its certification under section 58(3)(e) following that recall or |
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| | |
| | (6) | In section 64 (supplementary provisions for Part IV), after subsection (2) insert— |
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| | “(3) | In this Part of this Act, references to ‘not capable of understanding the |
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| | nature, purpose and likely effects of treatment’ are to be read in |
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| | accordance with the test established at section 3 of the Mental Capacity |
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| | |
| | (4) | References to a donee are to a donee of a lasting power of attorney |
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| | (within the meaning a section 9 of the Mental Capacity Act 2005) created |
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| | by a the patient, where the donee is acting within the scope of his |
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| | authority and in accordance with that Act. |
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| | (5) | References to a deputy are to a deputy appointed for the patient by the |
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| | Court of Protection under section 16 of the Mental Capacity Act 2005, |
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| | where the deputy is acting within the scope of this authority and in |
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| | accordance with that Act. |
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| | (6) | Reference to the responsible clinician shall be construed as a reference to |
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| | the responsible clinician within the meaning of Part 2 of this Act. |
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| | (7) | For the purpose of this section, a person restrains the patient if he— |
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| | (a) | uses, or threatens to use, force to require the doing of an act |
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| | which the patient resists, or |
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| | (b) | restricts the patients liberty of movement, whether or not the |
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| | (8) | References to a hospital include a registered establishment.”. |
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| | (7) | In section 119 (practitioners approved for Part 4 and section 118)— |
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| | (a) | in subsection (2)(a) for “in a registered establishment” substitute |
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| | “hospital or registered establishment or any community patient in a |
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| | hospital or establishment of any description or (if access is granted) other |
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| | (b) | in subsection (2)(b), leave out “in that home” and insert “there”, |
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| | (c) | after subsection (2) insert— |
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| | “(3) | In this section ‘establishment of any description’ shall be |
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| | construed in accordance with section 4(8) of the Care Standards |
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| | Authority to treat community patients (Mental Capacity Act) |
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| To move the following Clause:— |
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| | ‘(1) | The Mental Capacity Act 2005 (c. 9), is amended as follows. |
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| | (2) | In section 28 (Mental Health Act matters) after subsection (1) insert “(1A) |
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| | Section 5 does not apply to an act to which section 58A of the Mental Health Act |
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| Page 19, line 24 [Clause 29], at end insert— |
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| | ‘(c) | the following persons have been consulted about the making of the order |
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| | under section 17A and the conditions to which the patient is subject |
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| | (ii) | the nearest relative of the patient; |
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| | (iii) | any carer who the responsible clinician believes will play a |
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| | substantial part in the care of the patient after he leaves hospital; |
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| | (iv) | any person with parental responsibility; and |
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| | | the responsible clinician has taken into account any views expressed by |
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| | (d) | in this section “parental responsibility” has the same meaning as in the |
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| | Children Act 1989 (c. 41).’. |
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| Page 19, line 24 [Clause 29], at end insert— |
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| | ‘(c) | after subsection (3) insert— |
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| | “(4) | Subsections (1)(b), (c) and (d) above shall not apply if the |
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| | treatment is electro-convulsive therapy.”.’. |
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| Page 19, line 27 [Clause 29], leave out paragraphs (b) to (d) and insert— |
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| | ‘(b) | if the patient is not under Part III of the Act, (a patient concerned in |
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| | criminal proceedings or under sentence), the patient’s ability to make |
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| | decisions about the provision of medical treatment is significantly |
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| | impaired because of his mental disorder; |
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