Council of Europe - CDBIO Recommendation on autonomy in mental healthcare

Background

On 8 December 2023,In the framework of its Strategic Action Plan on Human Rights and Technologies in Biomedicine (2020-2025), the Steering committee for human rights in the fields of biomedicine and health (CDBIO) of the Council of Europe is preparing a Draft Recommendation on respect for autonomy in mental healthcare.

The Recommendation aims to provide common principles to promote a human rights-based approach in mental healthcare, safeguarding the rights and self-determination of persons with mental health problems.

Information on the Council of Europe's work in this area can be viewed here: https://www.coe.int/en/web/bioethics/mental-health-care-promoting-autonomy

Alzheimer Europe's response

Alzheimer Europe submitted our response on 30 January 2024. We welcomed the opportunity to comment on these recommendations and raised concerns with the approach taken, specifically, the broadness of the recommendations and the separate Explanatory Memorandum (EM), which was not included as part of the consultation.

Our response highlighted our belief that there is value in the development of recommendations in this area, with the issues identified in the footnotes of the draft recommendation (for inclusion in the EM) and in the Articles being vital to ensuring autonomy in mental healthcare.

However, we expressed concern at the broad nature of the Articles within the document, believing that:

  • They did not, by themselves, add to the existing policy landscape
  • They did not, by themselves, provide the necessary clarity or specificity for either policy-makers or practitioners
  • A separate Explanatory Memorandum, which provides vital clarifications and details for the recommendations, was an unhelpful approach.

We expressed concern that the recommendations were not accessible as the need to refer to footnotes/the EM, may deter people from using them. Alternatively, if applied without reference to these additional documents, the Articles may not be applied in the way intended by the CDBIO.

As such, we strongly urged the CDBIO to revise the Articles so that there is greater detail and specificity for each Article, without the need to refer to an EM or another document.

We further noted the difficulty in providing feedback on the Articles and the document as a whole, as many of the Articles are dependent on the clarification or further detail which is anticipated to be in the EM. These details were crucial to the understanding of both the intention behind, and the application of, the Articles, in relation to policy and practice.

As such, we urged the CDBIO to put the EM out for consultation, so that stakeholders have the opportunity to comment on both documents.

Alzheimer Europe's full response can be downloaded below.