Informed Consent to Treatment.
SEC. 8. Informed Consent to Treatment. - Service users must provide informed consent in writing prior to the implementation by mental health professionals, workers, and other service providers of any plan or program of therapy or treatment, including physical or chemical restraint. All persons, including service users, persons with disabilities, and minors, shall be presumed to possess legal capacity for the purposes of this Act or any other applicable law, irrespective of the nature or effects of their mental health condition or disability. Children shall have the right to express their views on all matters affecting themselves and have such views given due consideration in accordance with their age and maturity.
Advance Directive.
SEC. 9. Advance Directive.- A service user may set out his or her preference in relation to treatment through a signed, dated, and notarized advance directive executed for the purpose. An advance directive may be revoked by a new advance directive or by a notarized revocation.
Legal Representative.
SEC. 10. Legal Representative. - A service user may designate a person of legal age to act as his or her legal representative through a notarized document executed for that purpose.
(a) Functions. Aservice user's legal representative shall:
(1) Provide the service user with support and help; represent his or her interests: and receive medical information about the service user in accordance with this Act:
(2) Act as substitute decision maker when the service user has been assessed by a mental health professional to have temporary impairment of decision-making capacity;
(3) Assist the service user vis-a-vis the exercise of any right provided under this Act: and
(4) Be consulted with respect to any treatment or therapy received by the service user. The appointment of a legal representative may be revoked by the appointment of a new-legal representative or by a notarized revocation.
(b) Declining an Appoint-well!-. A person thus appointed may decline to act as a service user's legal representative. However, a person who declines to continue being a service user's legal representative must take reasonable steps to inform the service user, as well as the service user's attending mental health professional or worker, of such decision.
(c) Failure to Appoint. If the service user fails to appoint a legal representative, the following persons shall act as the service user's legal representative, in the order provided below:
(1) The spouse, if any unless permanently separated from the service user by a decree issued by a court of competent, jurisdiction, or unless such spouse has abandoned or been abandoned by the service user for any period which has not yet come to an end:
(2) Non-minor children;
(3) Either parent by mutual consent, if the service user is a minor:
(4) Chief, administrator, or medical director of a mental health care facilitv: or
(5) A person appointed by the court.
Supported Decision Making.
SEC. 11. Supported Decision Making. - A service user may designate up to three (3) persons or "supporters", including the service user's legal representative., for the purposes of supported decision making. These supporters shall have the authority to: access the service user's medical information: consult with the service user vis-a-vis any proposed treatment, or therapy; and be present during a service user's appointments and consultations with mental health professionals, workers, and other service providers during the course of treatment or therapy.
Internal Review Board.
SEC. 12. Internal Review Board. - Public and private health facilities are mandated to create their respective internal review boards to expeditiously review all cases, disputes, and controversies involving the treatment, restraint or confinement of service users within their facilities.
(a) The Board shall be composed of the following:
(1) A representative from the Department of Health (DOH);
(2) A representative from the CHR;
(3) A person nominated by an organization representing .service users and their families dui> accredited by the Philippine Council for Mental Health; and
(4) Other designated members deemed necessary, to be determined under the implementing rules and regulations (IRR).
(b) Each internal review board shall have the following powers and functions:
(1) Conduct regular review, monitoring, and audit of all cases involving the treatment, confinement or restraint of service users within its jurisdiction;
(2) Inspect mental health facilities to ensure that service users therein are not being subjected to cruel, inhumane, or degrading conditions or treatment:
(3) Motu proprio. or upon the receipt of a written complaint or petition filed by a service user or a service user's immediate family or legal representative, investigate cases, disputes, and controversies involving the involuntary treatment, confinement or restraint of a service user; and
(4) Take all necessary action to rectify or remedy violations of a service user's rights vis-a-vis treatment, confinement or restraint, including recommending that an administrative, civil, or criminal case be filed by the appropriate government agency.
Exceptions to Informed Consent.
SEC. 13. Exceptions to Informed Consent. — During psychiatric or neurologic emergencies, or when there is impairment or temporary loss of decision-making capacity on the part of a service user, treatment, restraint or confinement, whether physical or chemical, may be administered or implemented pursuant to the following .safeguards and conditions:
(a) In compliance with the service user's advance directives, if available, unless doing so would pose an immediate risk of .serious harm to the patient or another person:
(b) Only to the extent, that such treatment or restraint is necessary, and only while a psychiatric or neurologic emergency, or impairment or temporary loss of capacity, exists or persists:
(c) Upon the order of the service user's attending mental, health professional, which order must be reviewed by the internal review board of the mental health facility where the patient is being treated within fifteen (15) days from the date such order was issued, and every fifteen (15) days thereafter while the treatment or restraint continues; and
(d) That such involuntary treatment or restraint shall be in strict accordance with guidelines approved by the appropriate authorities, which must contain clear criteria regulating the application and termination of such medical intervention, and fully documented and subject to regular external independent monitoring, review, and audit by the internal review boards established by this Act.
Source: Supreme Court E-Library, Republic of the Philippines. Philippine laws are public documents (works of the government).
