LAW ASPECTS
IN PSYCHIATRY
Jitka Hüttlová
DEPARTMENT OF PSYCHIATRY
FN BRNO AND LF MU
HOSPITALIZATION
 voluntary/agreed - confirmed by patient informed
agreement signature
 involuntary/unwilling - without agreement of patient but
agreed by written agreement of court
 „Reverse/Discharge against medical advice“ - informed
disagreement, rejection of proposed/recommended
care - written
PRECONDITIONS FOR INVOLUNTARY
HOSPITALIZATION
Czech law 372/2011 Sb, § 38, par. 1:
a] Patient could be hospitalized without his
will in case of:
1] court commanded the protective treatment in the form of inpatient
care;
2] isolation, quarantine or treatment in order of public health law is
commanded;
3] medical health examination is commanded by criminal or public code.
PRECONDITIONS FOR INVOLUNTARY
HOSPITALIZATION (CONT.)
b] Patient instantly and seriously threatens
himself or others and has symptoms of mental
disorder or suffers from this disorder, or is
influenced by addictive substance and the
threat cannot be eliminated other way.
c] Health condition of patient requires immediate
treatment and the condition does not allow him to
give the formal agreement at the same time.
INVOLUNTARY/UNWILLING
TREATMENT
 Based on the Law 372/2011 Sb. § 38, par. 3:
Patient could be treated without his agreement only by the urgent treatment in the
case of:
a] health condition of patient does not allow
him to give the formal agreement;
b] serious mental illness causing, in the
case of untreated, high probability of
serious damage of health of patient.
COURT NOTIFICATION
 Based on the Law 372/2011 Sb. § 40:
 Medical institution is obliged to notify the respective court
about taking over the patient /due to reasons based on § 38,
par. 1, a) and c)/ without his will within 24 hours.
 Notification is also mandatory if patient or his legal
representative revoke the consent with hospitalization (agreed
earlier) and conditions for involuntary/unwilling treatment
continue.
RESTRICTIVE MEANS
Therapeutic and preventive steps to limit
patient in movement and behave.
Required due to serious psychomotoric
restlessness/agitation threatening the
surrounding or risk of self harm or suicide.
Aim is to prevent the patient in self harm, harm
of surrounding people or properties.
SANITY AND INSANITY
Person is considered sane if subjectively able
(mentally capable) to commit a crime.
Person is considered insane if, due to the
mental illness at the time of the act, is not able
to recognize his behave as illegal (impaired
recognition capabilities) or is unable to control
his behave (impaired control ability).
PROTECTIVE TREATMENT
 Exceptional institution to protect an individual or the
society.
 Complements or replaces given punishment for
Criminal offense.
 Protective treatment could be commanded (§ 99
Criminal Code) to the offender of any crime in case of
his insanity due to mental illness.
 Security detention could be commanded (§ 100
Criminal Code) to the offender for who the protective
treatment is insufficient to protect the society.
LEGAL CAPACITY
 Legal capacity – Czech law 89/2012 Sb. Civil Code
 Capability to acquire the rights by own acting and
committing to duties (§ 15).
 Every legally capable person has a mental capacity of
an average people and the capability to applicate it
with common care and caution; everyone can expect
this in legal relation from legally capable person (§ 4).
 Anyone cannot give up its own legal capacity, not even
a partially (§ 16).
 Legal capacity can be limited only by court (§ 56).
PRECONDITIONS FOR LIMITING OF
LEGAL CAPACITY
Limiting the Legal capacity could be done
solely for the sake of interest of person in
question (§ 55).
Limiting the Legal capacity of person can be
done only in case and due to impending
serious harm (§ 55).
Court can limit the Legal capacity of person
only in scope in which is the person unable,
due to his permanent mental illness, to legal
acts (§ 57).
LEGAL CAPACITY AND SANITY
“Legal capacity” is Civil code concept; does not
relate with Crime code concept “Sanity”.
“Sanity” (and consequent criminal
responsibility) is considered in every criminal
court proceeding, regardless the Legal
capability.
CAPABILITY OF DRIVING MOTORIZED
VEHICLE
 Czech law 361/2000 Sb, § 89a:
 If a doctor finds out that a patient is not capable of driving
motorized vehicle, he/she has to announce it to the municipal
authority.
 Organic disorders, psychotic disorders, mental retardation…..
POSSESSION OF FIREARMS PASS
 Czech law 119/2002 Sb, § 20, par 4.:
 If a doctor finds out that a patient suffering from severe mental
disorder has a firearms pass, he/she has to announce it to the
general practinional.
 Almost all mental disorders
Thank you for your attention