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The University of Southampton
Clinical Ethics and Law at SouthamptonResearch

Research project: Ethical Decision-Making around Serious Self-Harm by Healthcare Professionals in a Forensic Adolescent Mental Health Unit

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This project explores different healthcare professionals’ ethical decision-making around young people, who repeatedly and severely self-harm. Professionals in such instances are faced with a dilemma: to both respect a patients’ autonomy and act in their best interests.  

Graylingwell Hospital

In young people under sixteen years of age, questions of capacity further complicate the decision-making process. These ethical considerations are additionally confounded by the professionals’ personal beliefs towards, and tolerance of, self-harm, and the severe emotional and physical damage that could potentially be caused by such behaviour. Decisions are influenced by an increasing recognition that self-harm may provide an important coping mechanism for young individuals in such uniquely difficult circumstances, and the consideration of risks to other patients within the facility. Decision-making is informed by professionals’ understanding of the law and guidance, despite the fact this may contradict with what they personally consider to be in a patient’s best interests or with the guidance given to different professional groups.

For further information please contact Dr Kathleen Kendall, Dr Angela Fenwick or Harleen Johal

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