Letter: Castration and the Mental Health Act

Sir: You are wrong to say that the Mental Health Act Commission has to approve operations of surgical castration (24 September). It has no such responsibility. Its job is to monitor the operation of the 1983 Mental Health Act as it relates to patients detained under the act in hospital. The act provides safeguards for various types of medical treatment for mental disorder (ECT and medication) proposed for detained patients who are either unwilling or unable to give their valid consent.

In addition, it provides safeguards for the undertaking of psychosurgery and the surgical implantation of hormones for the suppression of male sexual drive, where they can be categorised as medical treatments for mental disorder. These apply to any patient for whom they are proposed. The commission administers all these safeguards.

As the law stands, the only time the commission would be statutorily entitled to become involved in any proposal to undertake surgical castration would be in the unlikely event that such a procedure was proposed for a patient detained under the act; and even then such involvement would arise from the commission's general obligations to protect detained patients and not because the act contains any safeguard about this specific procedure in relation to detained patients.

Yours sincerely,

WILLIAM BINGLEY

Chief Executive

Mental Health Act Commission

Nottingham

1 October