Reference no: EM133281551

David is a 38-year-old ex-military serviceman. He left the military 6 years ago and is married, his parents also live locally. Approximately 3 weeks ago David began to behave in an unusual manner, wandering through his house at night, refusing to eat and convinced that the government was monitoring his conversations and had listening devices in his house.

Following a referral from the GP, community mental health services assessed him at home and deemed it necessary to admit him for further assessment within an acute mental health inpatient hospital setting. He has been in the ward for approximately 4 days and is receiving care as a voluntary consumer. During this time, he has been isolated, withdrawn and appears frightened and suspicious of events and interactions around him.

Although he has been generally cooperative with staff, this morning he appears to be non- cooperative with staff requests to take his medication, that consists of a small dose of an antipsychotic as well as his regular antihypertensive medication. When staff gently request that he take his tablets he begins to lash out, thrashing and physically hitting the nurses; yelling that they are trying to hurt him and take his money. Due to the risk of David's behaviour on his physical safety and the safety of others, it is decided that his legal status should be reviewed under the Mental Health Act and that he should receive intramuscular sedation.

Before David is reviewed the medical officer gives a phone order to administer a sedative. The team leader directs that the sedation be given without David's consent due to the possible risk of him hurting himself and others. This directive is completed. During this time the process is noisy and disruptive to the ward and one nurse sustains a laceration to her arm while trying to restrain David.

David is extremely distressed throughout the entire process and firmly believes the nursing staff are trying to kill him.

Other patients are visibly upset by this action, and one mentions that it is barbaric, and they are going to report the nursing staff to the NMBA.

Identify and discuss contemporary ethical and legal responsibilities that apply in this situation.