As of 1 January 2020, the options for mandatory and compulsory treatment of vulnerable patients in mental health care (GGZ) have been determined in the law. Since then, the judge has issued a healthcare authorisation of birth control for women with severe psychiatric problems, including a case at the beginning of October 2021. André den Exter, Associate Professor of Health Law at Erasmus School of Law, discusses the interests that are affected by the decision of the judge in a column in het Nederlands Dagblad (ND).
The legislation can severely affect psychiatric patients who have the desire to have children. The right to family is an internationally recognised human right. Fortunately, the law has restrictions, according to Den Exter: “According to the new Mandatory Mental Health Care Act (Wvggz) and the new Care and Coercion Act (Wzd), mandatory medication, including birth control, can only be administered as a last resort to treat the mental disorder and to prevent serious harm to the patient or any third parties. That restriction is interpreted strictly, according to the available court rulings.” A disability or impairment, therefore, does not justify the imposition of compulsory care by the court.
A diabolical dilemma
Compulsory care is a serious encroachment of personal integrity, but at the same time, failing to intervene can lead to severe consequences for the patient or others that are involved. Therefore, a therapist is constantly faced with a diabolical dilemma, which is now passed on to the court because of the new legislation. For the judge, however, there are several points of view that he considers in his judgment. “First of all, there must be a legal basis for mandatory care, and the behaviour because of the disorder has to lead to serious disadvantages. It must also no longer be possible to voluntarily avert the serious disadvantage”, according to Den Exter.
If there are less radical measures that serve the same goal, the court will not claim mandatory care. According to Den Exter, this judicial intervention remains essential for the new system to work correctly. Practitioners should, therefore, not have to make a decision about such radical treatments for mental health patients. “The current system seems to work, but it is essential not to lose sight of patients rights”, according to Den Exter.