In acute inpatient mental health services, patients commonly demonstrate extreme behaviours. A number of coercive practices, such as locked doors, enforced medication and seclusion, are used in these settings to control such behaviours. The aim of this report is to explore briefly some of the contemporary debates pertaining to seclusion. A perusal of the literature reveals a clarion call to end the practice of seclusion, without consideration of feasible alternatives. It is hoped that this brief report will encourage further evidence-based (...) discussion and research initiatives on this important ethical topic. (shrink)

This note studies the 1650 edition of Hugo Grotius’s De iure belli ac pacis. Using online and card catalogues, we have located eighty-nine copies, thirty-seven of which we examined in person, with an additional six fully digitised copies online. We hope that this research note on the preliminary results will generate greater interest in this unduly neglected edition. The note shows how, despite the connection established in the history of seventeenth-century politics that emphasized the ties between Grotius and the Peace (...) of Westphalia, the reception of Grotius’s 1650 edition bore no relation to the debates at Osnabrück and Münster. However, this is an influential edition, cherished by collectors and authors. According to our findings, it would be reproduced in a number of later reprints. (shrink)

Locked inpatient units are an increasing phenomenon, introduced in response to unforseen abscondences and suicides of patients. This paper identifies some value issues concerning the practice of locked psychiatric inpatient units. Broad strategies, practicalities and ethical matters that must be considered in inpatient mental health services are also explored. The authors draw on the published research and commentary to derive relevant information to provide to patients and staff regarding the aims and rationales of locked units. Further debate is warranted in (...) relation to best practice. Inpatient staff need to be aware of their practice values, be able to access education and supervision and negotiate apparent contradictions. Further patient/clinician focused enquiry is necessary to mitigate the negative and stigmatising effects of locked mental health units. (shrink)

In this article, we clarify and describe the nature of nursing expertise and provide a framework to guide its identification and further development. To have utility and rigour, concept‐driven research and theories of practice require underlying concepts that are robust, valid and reliable. Advancing understanding of a concept requires careful attention to explicating its knowledge, metaphors and conceptual meaning. Examining the concepts and metaphors of nursing expertise, and how they have been interpreted into the nursing discourse, we aimed to synthesise (...) definitions and similarities between concepts and elicit the defining characteristics and properties of nursing expertise. In clarifying the concept, we sought to move beyond the ambiguity that currently surrounds expertise in nursing and unravel it to make explicit the characteristics of nursing expertise from published peer‐reviewed studies and structured literature synthesis. Findings indicate a lack of clarity surrounding the use of the term expertise. Traditional reliance upon intuition as a way of explaining expert performance is slowly evolving. Emerging from the analysis is a picture of expertise as the relationship between networks of contextual reasoning, understanding and practice. Striking absences in the discourse include limited explication of ethical reasoning and theorising a broader interpretation of expertise reflective of contemporary forms of nursing. (shrink)

This research note is the eighth instalment in our series of preliminary findings on the census and study of the reception of De iure belli ac pacis. The note presents a bibliographical description of Laurentius’ 1647 re-issue of the 1631 edition by Blaeu, considers Laurentius’ motivation and methods of production, lists and maps the currently known twenty-three surviving copies, and briefly describes two notable exemplars.

This research note offers a contextual overview of the printing history of Johann Blaeu’s 1646 octavo edition of Hugo Grotius’s De iure belli ac pacis (ibp). The note examines the printing process of the last edition that was prepared while Grotius was still alive, though it was published after his death. The note also sheds light on the theological dimension of some readers’ annotations, and concludes by discussing the impact this edition had on the modern versions of the text.

When clinical services aspire to quality improvement, creative and innovative approaches to old problems are needed to drive such change. Whilst new ef orts should be applauded, information on this topic can be somewhat grey from an ethical and research point of view. Within the mental health profession there is currently an expectation to routinely evaluate care and disseminate i ndings. The notion of service enhancements under the guise of routine practice is an interesting and untested ethical issue. Should clinical (...) innovation continue to enjoy such impunity as patient autonomy is often compromised as they are often compelled to accept treatment under the coercion of mental health legislation? We believe that it should not. All involvement in any form of research is voluntary, thus patients should also have the right to decline participation in quality projects if they wish to do so. (shrink)

In recent years, the law in the area of recovered memories in child sexual abuse cases has developed rapidly. See J.K. Murray, “Repression, Memory & Suggestibility: A Call for Limitations on the Admissibility of Repressed Memory Testimony in Abuse Trials,” University of Colorado Law Review, 66 : 477-522, at 479. Three cases have defined the scope of liability to third parties. The cases, decided within six months of each other, all involved lawsuits by third parties against therapists, based on treatment (...) in which the patients recovered memories of sexual abuse. The New Hampshire Supreme Court, in Hungerford v. Jones, 722 A.2d 478, allowed such a claim to survive, while the supreme courts in Iowa, in J.A.H. v. Wadle & Associates, 589 N.W.2d 256, and California, in Eear v. Sills, 82 Cal. Rptr. 281, rejected lawsuits brought by nonpatients for professional liability. (shrink)

Justifying involuntary psychiatric treatment on the basis of a judgment that a person lacks capacity is usually expressed in terms of a person’s ability to make a decision about his or her health and treatment. Typically, this relates to the ability to refuse treatment. Exactly what “capacity” means, however, and how one determines when another individual lacks capacity, or lacks sufficient capacity, in this context is particularly controversial, with the United Nations Committee on the Rights of Persons with Disabilities insisting (...) that involuntary treatment be abandoned altogether and capacity tests avoided.Capacity is a concept that has multiple meanings and applications across different disciplines and... (shrink)