Lacking Insight - Community Law

Lacking Insightthat they are treated with dignity and respect,and by judgments about the trustworthinessof authorities. Each of these factors has moreinfluence on judgments of procedural justice thando either evaluations of neutrality or evaluations ofthe outcome of the hearing.” (Tyler, 1996: 12)To better understand the implications of a theorysuch as therapeutic jurisprudence, it is useful to applythe theory to the practice of running of a tribunal – inthis case the Board. In what ways can the Boardoperate so as to act as therapeutic agent, and notharm those in attendance?The Board exists to review the treatment decisionsof a treating clinician. It is therefore important thatthe treating clinician’s decision to involuntarily treatthe person is the focus of the Review. The personreceiving involuntary treatment must feel as thoughthe Board is questioning the veracity of treatmentdecisions and professional judgment, and notmerely confirming the clinical opinion of the medicalprofessional. This is part of what has been referred toas the ‘consumer-centred hearing’. Other examplesof the consumer-centred process which influencedthis research project are:• Providing consumers with information about thereview process in a form that they can understandTo be able to properly participate in the reviewprocess a person needs to be provided withinformation, prior to the hearing, about his or herrights, and about the review process. This informationneeds to be provided in a format that they can easilyunderstand and remember (Freckelton, 2003: 46)and needs to cover the different stages of the reviewprocess. A written Statement of Reasons must beprovided to consumers and / or their advocatesafter every hearing.• Allowing the consumer to speak firstIt is important that the Board encourages theconsumer or the representative to speak first atthe hearing. This may be crucial if the personis medicated and the ability to concentrate hasbeen diminished, but it is also an assurancethat the treatment team will need to respond tothe person’s point of view and not vice versa. Itacknowledges that the person’s voice, experienceand perspective are the most important aspect ofthe hearing.• Ensuring consumers are heardThe Board appeared rushed and keen to resolveall the matters before lunch. As the involuntarypatient was exiting the room, and within earshot,one member stated to the others that she had toleave early. [Researcher observations].Speaking first is one thing, being heard is another.The Board should function in such a way as tobe able to spend the appropriate amount of timeon each individual hearing. There is a tendency toschedule too many hearings in the one session.This can mean that the hearing is rushed, andthat consumers leave the hearing feeling asthough they were unable to properly presenttheir version of events. A rushed process canlead to a sense of predetermination by the Board(Freckelton, 2003: 47).• Granting the consumer or their representativecomplete access to the clinical fileThe Board must conduct a fair hearing. It alsoneeds to conduct itself in such a way as toallow the person to feel that he or she has beengiven a fair hearing. The person must haveaccess to the same information provided to theBoard. Although it is acknowledged that theremay be exceptional circumstances when it is36