![]() conducted a study on remitted psychiatric patients. It is interesting to know the sociodemographic variables that determine such disclosure. Such written authorization from the patient may protect the psychiatrist in the Court of Law. Hence, as the lady herself wants her information to be shared with her spouse and the confidentiality clause is going to being breached, written informed consent should mandatorily be obtained from her, including permission as to how much can be disclosed and this should be documented in the patient's notes. The spouse may, unfortunately, use the disclosed information for any purpose (including divorce) and the lady may sue the treating doctor for breaching the confidentiality. Her spouse also wants to discuss regarding the diagnosis, treatment, and the need for and the safety of psychotropics in pregnancy. A typical scenario would be a lady under treatment for psychiatric illness for the previous 10 years suddenly turns up to the treating psychiatrist and discloses that she got married around a month back and now plans to conceive. Considering this as implied consent, till some time back, such disclosure was done in the absence of an explicit written informed consent. Few PWMI wants their information and diagnosis to be disclosed to such caregivers. In India, PWMI are mostly accompanied by caregivers. In clinical practice, however in certain situations, the PWMI themselves waive-off this confidentiality clause. This is one of the fundamental responsibilities of the psychiatrist. The patient–physician relationship is bound by the moral and ethical sanctity of confidentiality, more so in mental health. In view of the new challenges thrown by MHCA 2017, such as mental health capacity assessment, advance directive, nominated representative, etc., the authors stress regarding the need to actively collaborate with “the media, police, NGOs, human rights activists … and police.” There is an equal and strong need to involve the caregivers in framing mental health policies that are ethically and legally sound and at the same time tailoring to their needs and the ground realities of this developing country, such as poverty, illiteracy, unawareness regarding mental illness, stigma, discrimination, etc. No doubt, human rights of PWMI have to be protected at all times however, it cannot be one-sided. ![]() The caregivers of PWMI are the real ambassadors of mental health they sincerely understand the genuine service that psychiatrists have provided in this country over many decades. ![]() They also mention the non-representation of the Indian Psychiatric Society and inadequate address of the burden of care experienced by the caregivers. They commend the act for endorsing the rights (especially insurance) of PWMI and recommending decriminalization of suicide and the lesbian, gay, bi-sexual, transgender, questioning/queer (LGBTQ) community. In their article pertaining to MHCA 2017, the authors, critically evaluate the pros and cons of the new ACT. ![]()
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