Surviving the Sirens: Should there be advance directives for people with bipolar?

10 November 2016 - 17:00-18:30

LectureTania Gergel, IoPPN
Comment: Alex Ruck Keene, Barrister

New Hunt’s House, Lecture Theatre 2, Guy’s Campus


Bipolar Affective Disorder is a cyclical condition, with periods of remission and periods of illness, which often involve loss of decision-making capacity and damaging behaviour. For people with Bipolar, a self-binding (advance) directive (SBD), which commits them to treatment during future episodes, even if unwilling, can seem the most rational solution for an imperfect predicament. Nevertheless, efforts to establish a provision for SBDs are hampered by valid, but also paralysing, ethical, clinical and legal concerns. Paradoxically, the rights of people with Bipolar are being ‘protected’ through being denied an opportunity to protect themselves. We will present and discuss a model of an SBD which could represent a legitimate and ethically coherent form of self-determination.

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