Nursing home administrators face an unexpected ethical (and legal) dilemma when admitting new residents to skilled nursing care. The Nursing Home Care Act undercuts a traditional notion of informed consent in such a way that many residents may be admitted to a nursing home without ever consenting to treatment, or having a meaningful surrogate consent to their treatment. This is clearly an issue of nursing/medical ethics, as well as a font of potential legal liability for providing unauthorized care. American health care law is predicated on the notion of patient autonomous-direction. Within this notion exist a number of inter-linked rights: the right to self-determination, the right to give consent before treatment, the right to information forming the basis of consent and many others. Curiously, in senior care, as in perhaps no other major area of American health care law, the status of patient autonomous direction, especially with respect to consent before treatment, is less sacrosanct, the exceptions more numerous. This is especially true in the legal quagmire of involuntarily placing adults in nursing homes. I am most familiar with the Illinois Nursing Home Care Act and it will thus form the background of this discussion, but the Illinois Act is not dissimilar to Nursing Home Care Acts in many other states, at least inasmuch as the acts address the issue of involuntary admission. Clearly involuntary admission of a resident to a nursing home presents moral and ethical issues most families are not experienced in dealing with, not to mention attendant feelings of guilt for the family members and likely betrayal for the patient herself. However, for the health care provider, the nursing home, the struggle is a balance between determining the self-interest rights of the resident and the interests in rendering care.

from MindFreedom:

First the good news.

Within days of MindFreedom launching its Ray Campaign
on 7 November 2008 to stop the weekly involuntary outpatient
electroshock of Ray Sandford, his doctor has decided to "skip a
Wednesday."

Ray says that this coming Wednesday, 19
November 2008, for the first time in months, Ray will not be escorted
against his will, under court order, from his Minnesota home out in the
community to his 34th involuntary outpatient electroshock.

So there's a reprieve for Ray.

For one week.

The
bad news is that Ray's doctor said Ray's forced outpatient
electroshocks will resume on Wednesday, 26 November 2008, the day
before the USA holiday of Thanksgiving.

Ray said his involuntary shock will then continue every other week.

We
don't know if the one-week reprieve is because of the MindFreedom
campaign, but we know MindFreedom News readers are having an impact.

Since the MindFreedom first alert went out nine days ago, on 7 November 2008: