On 15 May 2014, the Minister for Health, The Hon Katy Gallagher presented the Mental Health (Treatment and Care) Amendment Bill 2014 (‘the Bill’) to the Australian Capital Territory Legislative Assembly (1). The Bill was subsequently passed on 30 October 2014. One recommendation contained in the proposed Bill is to extend powers of apprehension, which are currently only held by police officers, to approved ACT paramedics. The power may be exercised without regard to the patient’s decision making capacity. This paper explores some of the legal and ethical issues associated with the proposed legislation.
This paper reviews the Bill in light of underlying legal and ethical principles that are relevant to the treatment of the mentally ill and paramedic practice.
It is demonstrated that there are arguments both in favour of, and against the proposal to grant paramedics powers of apprehension.
Whether allowing paramedics to detain a person who is mentally ill will work in the best interests of the patients remains to be seen but caution must be exercised to protect the paramedic/patient relationship.
Australian Capital Territory, Parliamentary Debates, Legislative Assembly, 15 May 2014, 1539–1543 (Katy Gallagher, Minister for Health).
Mental Health (Treatment and Care) Amendment Act 2014 (ACT) s 37(1).
Mental Health (Treatment and Care) Act 1994 (ACT) s 37(1).
Mental Health Act 2000 (NSW) s 20.
Mental Health and Related Services Act 1998 (NT) s 31.
Mental Health Act 2000 (Qld) ss 32–36.
Mental Health Act 2009 (SA) s 56.
Townsend R, Luck M. Protective jurisdiction, patient autonomy and paramedics: the challenges of applying the NSW Mental Health Act. Australasian Journal of Paramedicine 2009;7(4). Available at: http://ajp.paramedics.org/index.php/ajp/index [Accessed 21 April 2015].
Shaban R, Wyatt-Smith C, Cumming J. The mental health patient in the pre hospital emergency care setting. In: Townsend R, Luck M, editors. Applied Paramedic Law and Ethics. Elsevier. p. 225.
George v Rockett (1990) 170 CLR 104.
R v Rondo (2001) 126 A Crim R 562.
Stuart v Kirkland-Veenstra (2009) 237 CLR 215.
Explanatory Statement, Mental Health (Treatment and Care) Amendment Bill 2012 (ACT) 2.
Eburn M. Emergency Law. 4th edn. Federation Press; 2013.
Established by, and referred to as ‘the Ambulance Service’ in the Emergencies Act 2004 (ACT) pt 4.1.
Email from Steve Druitt, Project Leader Mental Health Legislation Review, Mental Health Policy Unit ACT Government, to Michael Eburn, 28 January 2014.
Secretary, Department of Health and Community Services v JWB and SMB (1992) 175 CLR 218, 233 (‘Marion’s Case’).
Steer B. Paramedics, consent and refusal – Are we competent? Australasian Journal of Paramedicine 2007;5(1). Available at: http://ajp.paramedics.org/index.php/ajp/index [Accessed 21 April 2015].
In Re C (Adult: Refusal of Treatment)  1 WLR 290.
Gillick v West Norfolk and Wisbech Area Health Authority  1 AC 112, 169.
Mental Health (Treatment and Care) Amendment Bill 2013 (ACT) s 8(2).
Corderoy A. Ambos get frequent callers to hang up. The Sydney Morning Herald. 2013 Oct 30: 4.
Australia. Australian Capital Territory Auditor-General’s Office. Delivery of ambulance services to the ACT community. Canberra: Australian Capital Territory Government; 2009.
Lennox G. Review of ACT Ambulance Service: positioning the service to meet future challenges. Australian Capital Territory Government; 2010.
Roberts L, Henderson J. Paramedic perceptions of their role, education, training and working relationships when attending cases of mental illness. Australasian Journal of Paramedicine 2009;7(3). Available at: http://ajp.paramedics.org/index.php/ajp/index [Accessed 21 April].
Australian. Justice and Community Safety Directorate. Annual report. Canberra: Australian Capital Territory Government; 2011-2012.
A recent article in the Sydney Morning Herald reported that police in New South Wales will be required to undertake mandatory mental health training. Partridge, E. Mental illness and crime: All NSW police to get mental health training. Sydney Morning Herald [newspaper on the Internet]. 2014 Feb 24 [cited 2015 April 21]. Available at: www.smh.com.au/national/mental-illness-and-crime-all-nsw-police-to-get-mental-health-training-20140223-33aey.html.
Salem O, Forster C. Defensive medicine in general practice: recent trends and the impact of the Civil Liability Act 2002 (NSW). Journal of Law and Medicine 2009;17:235.
Shaban R. Paramedic clinical judgement and decision-making of mental illness in the pre-hospital emergency care setting: a case study of accounts of practice. Honours [thesis]. Griffith University; 2011.
Boland-Rudder H. Arrest legislation treads fine line: Liberals. The Canberra Times [newspaper on the Internet]. 2013 April 26. Available at: www.canberratimes.com.au/act-news/arrest-legislation-treads-fine-line-liberals-20130426-2iiao.html [Accessed 21 April 2015].
In Re F  2 AC 1, 75.
Kent v Griffiths  2 All ER 474.
Keller v Metropolitan Ambulance Service of Victoria  VSC 222.
Neal v Ambulance Service of New South Wales  Aust Torts Reports 81-988.
Sullivan v Moody (2001) 207 CLR 562.
Australian Capital Territory v Crowley, Commonwealth v Crowley (2012) 7 ACTLR 142.
Hill v Chief Constable of West Yorkshire  2 WLR 1049.
Australian Federal Police Act 1979 (Cth) s 64B.
Crowley v Commonwealth (2011) 251 FLR 1.
O’Meara P. Paramedics marching towards professionalism. Australasian Journal of Paramedicine. Australasian Journal of Paramedicine. 2009;7(1). Available at: http://ajp.paramedics.org/index.php/ajp/index [Accessed 21 April 2015]
Eburn M, Bendall J. The provision of ambulance services in Australia: a Legal argument for the national registration of paramedics. Australasian Journal of Paramedicine. 2010;8(4). Available at: http://ajp.paramedics.org/index.php/ajp/index [Accessed 22 April 2015]
Health Practitioner Regulation National Law (ACT) s 5 (definition of ‘health profession’).