The position of the medical profession in regard to certificates of mental unsoundness and civil incapacity / by T.S. Clouston.

  • Clouston, T. S. (Thomas Smith), 1840-1915.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The position of the medical profession in regard to certificates of mental unsoundness and civil incapacity / by T.S. Clouston. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    such system of formal medical certificates as the present must be continued. The only question is—Who is to give them ? I am in favour of the present system of the whole profession retaining the power of granting such certificates instead ot deputing it to special Government-paid officials. I do not even approve of one of the two certificates being granted by such an official; for if the family doctor had granted the first certificate in any case, and the Govern- ment official refused to grant the second, the former would be in a very unpleasant and dangerous position indeed. I contend, how- ever, that the medical man who certifies a case of insanity should be in exactly the same position as a witness who has been sum- moned to a Court and gives evidence there in answer to questions asked. If he does not say wliat he knows to be untrue, and if he has no viala ficles, the witness is protected by the Court from any consequences that may arise from his testimony. So should the doctor be in giving a truthful lunacy certificate. Then arises the question—If two medical certificates in statutory form are given in regard to any case, is the sheriff to judge of the sufficiency of the facts indicating insanity contained in them, and grant or refuse the “ Order” to receive the patient into the asylum, according as he thinks those facts sufficient or insufficient ? At present different sheriffs act on different principles in regard to this vital matter. One acts judicially, another ministerially. I have known a sheriff refuse to grant an order because it was stated in one of the certificates (both of which contained abundant facts indicating insanity) that the woman had been confined the day before. Being a kind-hearted man, he thought it shocking to send any woman to an asylum the day after her confinement; and being the judge in the case, and there being no appeal, though there was imminent risk of the insane mother strangling her baby and jumping out of the window with not a soul to look after her, those risks had to be run. And I have received an order from another sheriff for the admission of a patient, when one of the certificates under “ Facts indicating insanity observed by myself,” stated, “ I could discover no fact indicating insanity.” There being an express clause in the Act absolutely prohibiting any patient being received into an asylum except on certificates containing facts indicating insanity observed by the certifier, I considered I could not admit the patient, notwithstanding the sheriff’s order, and refused to do so. It is notorious that sheriffs, or rather the sheriff-clerks, do not see that the formal legal portion in the first parts of the certificate before “ Facts indicating insanity observed by myself” is correctly filled in, which is just the part they ought specially to see to, in my opinion. In England a certificate is not valid except the certifier’s exact medical qualification is put in. This is constantly omitted here, and yet the sheriffs sign the order. There is a formal English decision that if the patient is not designated and his residence put in, the certificate is invalid