Legal Rights of Patients in Psychiatric Hospitals: Decision-Making Authority

Hello, I would like to inquire about legal issues regarding hospitalization regulations?

I would like to inquire whether it is permissible for a psychiatric hospital to stipulate that only the person who admitted a patient can make all decisions regarding the patient, such as visits, the use of health insurance and bank cards, and discharge or temporary leave.
The patient in question is my mother, but she was admitted to the hospital by my aunt.
When my aunt first admitted her to the public hospital, the doctor assessed that she could be discharged for follow-up treatment.
Subsequently, my aunt transferred my mother to a private hospital.
The hospital consistently cites my aunt's regulations as the reason for denying outings or visits.
Therefore, I would like to know if such regulations are legal and if there are any relevant provisions.
My mother is neither under involuntary hospitalization nor has she been declared under guardianship.
Additionally, my mother is responsible for her own hospitalization expenses, not my aunt.
It seems my aunt may have brought my mother in with the intention of selling her house.
The house has been sold, and it has been less than six months since the first hospitalization; now, it has been seven years.
According to Article 38, Section 1 of the Mental Health Act, a psychiatric medical institution must notify the patient or their guardian to arrange for discharge when the patient’s condition is stable or improved and there is no need for continued hospitalization; patients cannot be held without cause.
I wish to take my mother to a public hospital for a psychiatric evaluation, but my aunt is restricting her from going out.
Therefore, I would like to ask if there are any legal regulations that would allow the hospital to impose such restrictions.

npa, 20~29 year old female. Ask Date: 2020/02/08

Dr. Wu Enliang reply Psychiatry

My understanding is that mental health institutions operate in accordance with the Mental Health Act.
However, since I am not a legal expert, I recommend consulting with a legal professional and the relevant authorities in your area (such as the Department of Health).

Reply Date: 2020/02/08

More Info

In psychiatric hospitals, the legal rights of patients regarding decision-making authority can be complex and vary by jurisdiction. Generally, patients have the right to make decisions about their treatment and care, especially when they are not under involuntary commitment or guardianship. In your case, it appears that your mother is not under such restrictions, which raises important questions about the authority of the person who admitted her (your aunt) and the hospital's policies.

Firstly, under mental health laws, particularly those similar to the one you referenced (Article 38 of the Mental Health Act), a patient should not be held in a psychiatric facility without a valid reason once their condition stabilizes. This means that if your mother is stable and does not require further treatment, she should be allowed to leave the hospital. The law typically mandates that the hospital must inform the patient or their legal guardian about the discharge process.

Regarding the authority to make decisions about your mother's care, it is crucial to determine whether your aunt has legal guardianship or power of attorney over your mother. If your mother has not been declared incompetent and has not assigned decision-making authority to your aunt, then your mother retains the right to make her own decisions, including who can visit her and how her financial resources (like health insurance and bank cards) are managed.

If your aunt is making decisions that restrict your mother's rights without legal authority, this could be a violation of your mother's rights. You may want to consult with a legal expert who specializes in mental health law to understand the specific regulations in your area and to explore options for challenging your aunt's authority. It may also be beneficial to speak with the hospital administration about your concerns, as they may have protocols in place to address situations where a patient's rights are being infringed upon.

Additionally, if your mother wishes to seek a second opinion or undergo a psychiatric evaluation at another facility, she should be allowed to do so unless there are legal restrictions in place. If the hospital continues to deny her requests based on your aunt's decisions, it may be necessary to escalate the matter to a higher authority, such as the state health department or a patient advocacy group.

In summary, while psychiatric hospitals have protocols and legal frameworks to follow, patients generally have rights that protect their autonomy, especially when they are not under involuntary treatment or guardianship. It is essential to clarify your mother's legal status and consult with professionals who can provide guidance on how to navigate this situation effectively.

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