PBU & NJE v Mental Health Tribunal (ECT case)
Overview
PBU & NJE v Mental Health Tribunal involved two appeals challenging VCAT orders for compulsory electroconvulsive treatment (ECT). Both patients had schizophrenia but disputed their diagnoses while accepting they had mental health issues. VCAT found they lacked capacity to give informed consent to ECT. The Supreme Court of Victoria ruled VCAT erred by requiring patients to accept their diagnosis as a prerequisite for capacity, and by setting too high a threshold for decision-making ability. The court emphasized non-discriminatory application of capacity tests and upheld patients' rights to self-determination under the Charter of Human Rights.
Key insights
Key Insights
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Capacity cannot be denied solely for rejecting psychiatric diagnosis or treatment
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Mental illness doesn't automatically equal incapacity - presumption of capacity applies
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Functional capacity test focuses on abilities, not actual decision outcomes
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Low threshold required: general understanding, not detailed rational decision-making ability
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Unwise decisions don't indicate lack of capacity - dignity of risk
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Non-discriminatory application essential - same standards as non-mentally ill persons
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Patient views/preferences must be considered even when lacking capacity
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Paradigm shift from paternalistic best-interests to rights-based supported decision-making
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