Section 57 Neurosurgery — MRCPsych Paper B MCQ

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HardMental Health LawSection 57 NeurosurgeryMRCPsych Paper B

In England, a capacitous informal patient with severe treatment-refractory obsessive-compulsive disorder is being considered for a planned stereotactic anterior capsulotomy. Which section of the Mental Health Act 1983 provides the specific statutory safeguards governing this neurosurgery for mental disorder, despite the patient not being detained?

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Correct answer: E — Section 57

Section 57 is correct. It governs neurosurgery for mental disorder, including an ablative anterior capsulotomy, and applies to both detained and informal patients. The patient must personally consent; a SOAD and two other CQC-appointed persons must certify that the patient has capacity and has consented, and the SOAD must also certify that the treatment is appropriate. Section 58 principally concerns medication after the initial three-month period of detention. Section 63 permits treatment for mental disorder without consent in many detained patients but is expressly displaced where section 57 applies. Section 62 concerns immediately necessary emergency treatment and does not provide the ordinary route for planned elective psychosurgery. Section 3 authorises detention for treatment rather than this specific intervention.

Reference: Department of Health, Mental Health Act 1983: Code of Practice, chapter 25, paragraphs 25.7–25.10, 2015. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/396918/Code_of_Practice.pdf