The possibility of the right to conscientiously object from enforcing treatment

Dear Readers,

The Critical Mental Health Nurses’ Network want to begin a profession-wide conversation about the possibility of a right to conscientious objection to enforcing treatment.

This is a serious and complicated subject and needs to be handled with great care. However, we believe that this is an important conversation to have at this time, a time in which the professional, intellectual and personal reasons for concern about forced treatment have been brought into new focus within a changing ethical and evidential context. Initially, we would like to collect together a group of nurses, student nurses and others who can contribute thoughtfully to this conversation. We would also like to involve service users, next-of-kin/carers, psychiatrists, psychologists, social workers and hospital managers.

Key points to remember:

If you would like to be part of this discussion, please contact us through this website’s ‘contact us’ page. We are not asking you to share your views about forced treatment at this stage, just to identify yourself as wanting to contribute so that the CMHNN can assess the best way of bringing us together.

It is not the intention of this discussion to create some kind of position statement about whether forced treatment is finally ethical or finally unethical and, as a network of critical thinkers, we would probably be skeptical about binary positions. We are not at this stage planning to consider if the law is morally wrong. We plan to exclude wider questions about detention itself. Instead, our aim is to establish whether we believe that present circumstances suggest that there should be a right for individual mental health nurses to object to taking part in forced treatment as a matter of personal/professional conscience and for this right to make it safe for them to refuse to participate (either in totality or in specific circumstances). If we feel that this right is something for which we should campaign, we will then need to discuss ways in which that campaign should take place.

We already know that issues of blame and responsibility between professional groups add heat and are part of the reason that this subject is so rarely properly discussed. Our beginning position is that forced treatment has many causes and deciding upon blame or a ‘final cause’ is not necessary. This is an hugely important, sensitive and broad subject but actually our focus is a relatively narrow one: should mental health nurses have the right to conscientious objection from enforcing treatment? 

5 thoughts on “The possibility of the right to conscientiously object from enforcing treatment

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  1. The idea of refusing to enforce treatment was a live debate when I was a student nurse some 35 years ago. Psychiatric nurrses did refuse to participate in in ECT at that time a focus for dissent however they did not progress far in the profession. Mental health nurses must refuse to enforce treatment if it is abusive or uncaring and given the lack of any really convincing evidence base for most of the treatments we employ then we have good grounds. However I would advise any mental health nurse who wishes to refuse to enforce treatment to record all their multidiscilinary meetings and ensure that their objections to enforcement are well grounded and recorded. Having done that any mental health nurse refusing to enforce treatment should also record what further actions they took to raise their concerns as the NMC and Coroner may well hold you to account


    1. Dear Delapole1,
      We think this is a very valid point… but instead of beginning the conversation here, which will begin the discussion in a way that will be harder to access later, please can we ask you to take part in our discussions (probably kicking off in about 2 weeks) and make it again?! Thanks.
      We are being joined by a Dr of law on the subject of CO and this excellent point will definitely be one to discuss with her. Thanks.


  2. Under who you would like to be involved why no mention of those who have been the recipients of forced ‘treatment’? Donct those voices count?


    1. Dear Graeme,
      Thank you for you comment. In the wording above we do mention ‘service-users’. On twitter we have made it clear that ALL would be welcome to join this discussion. Hope that helps.


  3. Is this debate still live? I have on several occasions refused to enforce treatment for several reasons’ individual to each situation. I’ve recently found your page and love the ideology. Would like to involved in some way if possible. 3 years qualified, B6 charge nurse in acute adult admissions, struggling to align my personal and professional morals with what current day MH nursing is evolving into.


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