Executive to allow banned brain surgery

Kate Foster, Health Correspondent kfoster@scotsman.com

The Scotsman To submit a Letter to the Editor: letters_TS@scotsman.com

June 12, 2002

Mentally ill patients will undergo brain surgery without their consent under a controversial law being introduced in Scotland which directly contravenes guidelines set out by the United Nations.

Next month, the Executive will introduce legislation allowing doctors to perform lobotomies on patients who are too mentally ill to agree to the operation.

The irreversible procedure, known as neurosurgery for mental disorder (NMD), involves using a laser to destroy a small part of the brain tissue. It is carried out on patients suffering some forms of severe mental illness in an attempt to improve their condition.

However, expert opinion over whether the operation is effective is divided. In 1992, the UN passed a resolution against the procedure being performed without consent and guidelines set out by the Council of Europe and the Law Society of England and Wales also state patients must agree to the operation.

Britain is currently the only country in western Europe which carries out the NMD and it is currently against the law for a patient to be given the operation, also known as psychosurgery, without consent.

But on 1 July, the legislation will be changed in Scotland, under the Adults with Incapacity Act 2000 so that it will be possible for the operation to be performed on someone who is not capable of consenting.

It is not known why the operation helps some patients. Campaigners warn consent is vital because the procedure irreversibly changes the subject's personality.

The former child star Lena Zavaroni, who suffered from depression and anorexia, died of complications following the operation in 1999.

In the past ten years, 28 patients in Scotland have undergone psychosurgery, but campaigners warn the legal move could see numbers increase dramatically as restrictions are removed.

Richard Norris, the policy director of the Scottish Association for Mental Health, said the organisation would call on MSPs to oppose the regulations.

He added: "It is surprising that the Executive has chosen to ignore professional opinion as well as organisations such as ours which have consistently campaigned against the introduction of this measure.

"Ten years ago, the United Nations passed a resolution banning this operation from being given without proper consent. Practitioners in Dundee, the only place in Scotland where it is carried out, have themselves said that it should not be given unless patients agree."

An Executive spokeswoman last night defended the measure, saying it was being taken to allow patients incapable of consenting to treatment to have the operation.

She said: "The Adults with Incapacity Act is designed to protect the rights of some of the most vulnerable people in society by allowing them to receive medical treatment where they lack capacity to make a decision about consenting to that treatment.

"Neurosurgery for mental disorders is one of the treatments detailed in the regulations for which substantial safeguards are required before treatment can be carried out. In this case, the approval of the Court of Session is required, taking into account the views of clinicians, carers and relatives, and where possible the patients themselves."

The spokeswoman added: "Treatment will only be approved where it is judged to safeguard or promote the mental health of the adult and the adult does not oppose or resist the treatment.

"There is only a small number of this type of operations carried out in Scotland each year.

"The regulations were made following wide consultation, including with the Scottish Association for Mental Health, and are based on the recommendations of the Millan committee and the Scottish Law Commission.

"Both of these organisations took the view that adults with incapacity should not be prevented from accessing this treatment, recognising that such adults may well include people who would most benefit from this type of treatment."

Margaret Smith MSP, the Liberal Democrat convener of the Scottish Parliament's health committee, said it would investigate the matter at its meeting next week.

http://www.thescotsman.co.uk/scotland.cfm?id=639752002