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Biomedical Ethics Case Study

Case Study


Mental illness remains one of the most contentious ethical issues with respect to medication because the patient is considered incapable of making sound decisions. In the case of Mr. Scott Starson, the patient is erratic and threatens to kill his neighbors. He is diagnosed with bipolar disorder or schizophrenia that is characterized by psychotic behavior, anxiety and mood swings. The attending physicians prescribed anti-psychotic, anti-anxiety and mood stabilizing drugs for Mr. Starson to help restore his mental state while he is at the center. Although Mr. Starson acknowledges that he has mental health problems, he refuses to take medication. He believes taking the prescribed medication gets in the way of his scientific research and thus confines his thinking capabilities (CBC News, 2003). According to the medical review from Ontario, Mr. Starson was deemed incapable of crime after threatening his neighbors considering his mental health condition.

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The patient forwarded his case to the judicial review, which started at superior court and was forwarded to the court of appeal that held a similar view to the medical review board. The problem was then supervised by the Supreme Court where it was ruled that Mr. Starson was competent of making decisions regarding his medication (CBC News, 2003). Physicians hold their stand on the recommended medication and claim that it would help to control his behavior in society. They state that Mr. Starson is incapable of making sound decisions regarding his treatment. The major topic of concern in the case study is morality versus law as far as mental health is concerned. Considering all reviews and the final ruling on Mr. Starson’s case, the thesis of the Capability and Consent Board has the efficient argument that decision-making for mental health should be based on moral obligation.

Argument 1

The first argument in the case is represented by the Capability and Consent Board which suggests that Mr. Starson should take the prescribed medication to control his mental illness. According to the board, the patient is unable to make sound decision regarding his medication. Their decision is drawn from the Canadian Healthcare Consent Act. The Act states that an individual is liable for their decision regarding suggested medication if they can interpret information with respect to the given prescription (Beauchamp & Childress, 2001). According to the doctor’s handling of Mr. Starson’s case and the assessment by the Capability and Consent Board the patient is incapable of making decisions. The argument’s substantial motion is that mental illness incapacitates the patient’s ability to reason and thus they cannot make decisions regarding medication. The morally relevant action in the case was the decision made by the physicians. Physicians hold their stand on the recommended medication and claim that it would help the patient to control his behavior in society. The idea to put Mr. Starson on prescription is applauded by his mother, who views the declaration by the court to disregard medication as a backward step in her son’s recovery. It is the moral duty of the mother to consider her son’s well-being and, therefore, the prescription as explained by physicians would ensure the patient’s recovery. Mr. Starson’s mental case has drawn the attention of the Ontario Review Board, which has suggested his 12 month retention. Mr. Starson is expected to stay at the center for Addiction and Mental health in Toronto since he was found to be incapable of crime after threatening his neighbors. The decision is ethically approved since he has become a danger to the community. The downside of the argument is that the board does not fully interpret the law stipulated in the Canadian Healthcare and Consent Act (Kluge, 1991). The objection to the argument could be based on the partial interpretation of the healthcare act.

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Argument 2

Another view is presented by the Supreme Court that argues that Mr. Starson is competent of making decisions regarding his treatment. The court states that he can understand and interpret the prescribed medication (Collier & Haliburton, 2011). The Supreme Court based their remarks on the Canadian Healthcare Consent Act and since Mr. Starson could understand and interpret his medical prescription he was deemed capable of decision-making by the Court. The Supreme Court explained that the Consent and Capacity Board made a judgment based on what was best for the patient and not on a strict interpretation of the law. The court persists that a patient’s competence cannot be best on standards of best interest but, on the interpretation of the law. The crucial view presented by the argument is that the law is fully interpreted and fair judgment given with respect to the case at hand. The legal obligation of the court was to provide Mr. Starson with the correct interpretation of the Healthcare Act. The court interprets the law to give judgment as opposed to focusing on personal interests. The argument falls short when it focuses on the law and overrides the fact that the patient in question suffers from mental illness that daunts the rationality of the patient’s decision-making capability. The objection to the argument is based on the medical understanding of Mr. Starson’s mental state.


Considering the case and arguments presented by the healthcare and judicial review, Mr. Starson is a subject of contention because of his mental health. The suggestions from both sides of the argument are considerable since they have enacted the laws that support their views. According to the physician’s view, Mr. Starson should remain on medication. The prescription would help to contain his erratic behavior that has become a threat to his neighbors rendering him as a risk to the society (Hébert, 2014). On the other hand, the judicial review under the Supreme Court counters the suggestion by the healthcare sector referring to an Act by the Canadian Healthcare Consent. The Act stipulates that an individual’s competence to make decisions with respect to their medication is not decided based on the interest standard of the person (Baylis, 2012). It is therefore, recommended that the patient is given medication seeing that he remains under the responsibility of the physicians. Mr. Starson should take medication because he is a mental health patient and cannot be given the responsibility to determine his own treatment despite being able to interpret the prescription. He is a threat to the society, and the treatment helps to put his erratic behavior in check and might allow him to live in the society after the 12-month stay at the mental health facility. Although the court makes substantial remarks, it fails to give consideration to the fact that the patient in question has been deemed incapable of crime after threatening his neighbors. The decision was reached on account of his mental health. Therefore; he cannot make a decision with respect to the medication prescribed for his illness.

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