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Zero tolerance of violence by users of mental health services: The need for an ethical framework

  • G. M. Behr (a1), J. P. Ruddock (a2), P. Benn (a3) and M. J. Crawford (a3)
Summary

Concerns about violent conduct of service users towards healthcare staff have prompted a ‘zero tolerance’ policy within the National Health Service. This policy specifically excludes users of mental health services. We attempt to challenge artificial distinctions between users of mental health and other services, and propose an ethical underpinning to the implementation of this policy.

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Copyright
Corresponding author
Dr G. M. Behr, Consultant Psychiatrist and Honorary Senior Lecturer in Psychiatry, Paterson Centre for Mental Health, 20 South Wharf Road, London W2IPD, UK. Tel: +44(0)20 7266 6030; fax: +44(0)20 7289 1583; e-mail: graham.behr@nhs.net
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Declaration of interest

None.

Footnotes
References
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American Medical Association Council on Ethical and Judicial Affairs (2002) Opinion 10.02, patient responsibilities. In Council on Ethical and Judicial Affairs, American Medical Association. The Code of Medical Ethics: Current Opinions, pp. 140142. Chicago, IL: American Medical Association.
Beauchamp, T. L. & Childress, J. F. (1989) Principles of Biomedical Ethics (3rd edn). Oxford: Oxford University Press.
British Medical Association (2003) Violence at Work: The Experience of UK Doctors. London: Health Policy and Economic Research Unit.
Department of Health (1999) NHS Zero Tolerance Zone: We Don't Have To Take This. Resource pack. London: Stationery Office.
Health and Safety Executive (2001) Violence at Work: New Findings from the British Crime Survey 2000. London: Home Office and HSE.
Hobbs, F. D. & Keane, U. M. (1996) Aggression against doctors: a review. Journal of the Royal Society of Medicine, 89, 6972.
National Institute for Mental Health in England (2003) Personality Disorder: No Longera Diagnosis of Exclusion. London: NIMHE.
Richardson, G. (1993) Law, Process and Custody: Prisoners and Patients. London: Weidenfeld and Nicolson.
Szmukler, G. (2001) A new mental health (and public protection) act. BMJ, 322, 23.
Watts, D. & Morgan, G. (1994) Malignant alienation: dangers for patients who are hard to like. British Journal of Psychiatry, 164, 1115.
Wells, J. & Bowers, L. (2002) How prevalent is violence towards nurses working in general hospitals in the UK? Journal of Advanced Nursing, 39, 230240.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Zero tolerance of violence by users of mental health services: The need for an ethical framework

  • G. M. Behr (a1), J. P. Ruddock (a2), P. Benn (a3) and M. J. Crawford (a3)
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