Chapter XVI: Mental Unsoundness (2)

(_a_)--a Justice of the Peace for ____, _or_ His Honour the Judge of the County Court of ____, _or_ ____ Stipendiary Magistrate for ____.

(_b_) Full postal address and rank, profession, or occupation.

(_c_) At least twenty-one.

(_g_) Some day within 14 days before the date of the presentation of the petition.

(_h_) Here state the connection or relationship with the patient.

(_k_) Full Christian and surname.]

53 Vict. c. 5.--Sched. 2, Form 1.

PETITION FOR AN ORDER FOR RECEPTION OF
A PRIVATE PATIENT

In the Matter of_______________________________
a person alleged to be of unsound mind.

_To_ (_a_)____________________________________
____________________________________
____________________________________

The Petition of_________________________________________
of (_b_)_________________________________________
_________________________________________

in the County of________________________________________

1. I am___________(_c_) years of age.

2. I desire to obtain an Order for the Reception of
________________________________________________
as a person of unsound mind, in the Haydock Lodge Licensed House,
situate at Newton-le-Willows, Lancashire.

3. I last saw the said__________________________________
at______________________________________________________
on the (_g_)_______day of________________ 19_______

4. I am (_h_)_______________________________ of the
said____________________________________________________

(or if the Petitioner is _not connected_ with or related
to the or Patient, _state as follows_:)

I am not related to or connected with the said__________
________________________________________________________

The reasons why this Petition is not presented by a relation
or connection are as follows:

The circumstances under which this Petition is presented by
me are as follows:--

5. I am not related to or connected with either of the persons
signing the certificates which accompany this petition as (_where
the petitioner is a man_) husband, father, father-in-law, son,
son-in-law, brother, brother-in-law, partner, or assistant (_or
where the petitioner is a woman_) wife, mother, mother-in-law,
daughter, daughter-in-law, sister, sister-in-law, partner,
or assistant.

6. I undertake to visit the said________________________
__________________________personally, or by some one specially
appointed by me, at least once in every six months while under
care and treatment under the order to be made on this petition.

7. A statement of particulars relating to the said_____________
______________________________________accompanies this petition.
_If it is the fact, add_: 8. The said_____________________
has been received in the Haydock Lodge Licensed House,
Newton-le-Willows, under an Urgency Order dated the____________
_______________________________________________________________

The petitioner therefore prays that an order may be made in
accordance with the foregoing statement.

=Signed= (_k_)_______________________________________

Date of Presentation of the Petition, this____________
day of___________________ 19_________

[Sidenote: (_a_) Name of Patient.

(_b_) To be signed by the petitioner.]

53 Vict. c. 5, s. 31.

When neither Certificate is signed by the Usual Medical
Attendant.

I, the undersigned, hereby state that it is not practicable to
obtain a Certificate from the usual Medical attendant of (_a_)
__________________________________________________________________
for the following reason, viz.:--

(=Signed=) (_b_)______________________________
_______________ 19____________

Form 2.

STATEMENT OF PARTICULARS REFERRED TO IN THE
ANNEXED PETITION

_If any particulars are not known the fact is to be so stated._

[Where the patient is in the petition or order described as an idiot,
omit the particulars marked ►]

The following is a Statement of Particulars } __________________
relating to the said } __________________

Name of patient, with Christian name at } __________________
length } __________________

Sex and Age __________________

► Married, single, or widowed __________________

► Rank, profession, or previous occupation } __________________
(if any) } __________________

► Religious persuasion __________________

Residence at or immediately previous to } __________________
the date hereof } __________________

► Whether first attack __________________

Age on first attack __________________

When and where previously under care } __________________
and treatment as a lunatic, idiot, or } __________________
person of unsound mind } __________________

► Duration of existing attack __________________

Supposed cause __________________

Whether subject to epilepsy __________________

Whether suicidal __________________

Whether dangerous to others, and in } __________________
what way } __________________

Whether any near relative has been } __________________
afflicted with insanity } __________________

Names, Christian names, and full postal } __________________
addresses, of one or more relatives }
of the patient } __________________

Name of the person to whom notice of } __________________
death to be sent, and full postal } __________________
address, if not already given } __________________

‡Name and full Postal Address of the } __________________
usual Medical Attendant of the Patient } __________________

‡When the Certificate is not signed by
the usual Medical Attendant, the Certificate
on the other side must be filled out.

[Sidenote: (_a_) _When the petitioner or person signing an urgency order is not the person who signs the statement, add the following particulars concerning the person who signs the statement._]

Signed (_a_)

_Name, with Christian
Name at length_________________________________
_Rank, Profession or
Occupation_ (_if any_)____________________
_How related to, or
otherwise connected
with the Patient_______________________________

53 Vict. c. 5. s. 7 (4).

=When a previous Petition has been dismissed=.

[Sidenote: (_a_) Name of Patient.

(_b_) Name of asylum, hospital, licensed house, or single charge.

(_c_) Justice of the Peace for ———, or Judge of County Court of ——, or Stipendiary Magistrate for ———]

I, the undersigned, hereby state that a former Petition for
Reception of (_a_)___________________________________________
into (_b_)___________________________________________________
was presented to__________________________________________________

(_c_)________________________________________________________
in the month of________________ 19_______, and dismissed.

Herewith is a copy (furnished by the Commissioners in Lunacy)
of the statement sent to them of the reasons for its dismissal.

Signed________________________________________
________________ 19________

Note.--_This Copy is to be obtained from the Commissioners
in Lunacy by the Petitioner at his own expense._

An Order for Reception of a Lunatic is to be obtained upon a private application by Petition to a Judge of County Courts, or Stipendiary Magistrate, or Metropolitan Police Magistrate, or specially appointed Justice of the Peace. The petition is to be presented, if possible, by the husband or wife, or by a relative (_i.e._ a lineal ancestor or lineal descendant, or lineal descendant of an ancestor not more remote than great-grandfather or great-grandmother) of the Lunatic, and is to be accompanied by a Statement of Particulars and two Medical Certificates on separate sheets of paper. One of the Medical Certificates accompanying the Petition must, if practicable, be by the usual Medical Attendant of the Lunatic; if not by him, the reason must be stated (see Form above). If a previous Petition has at any time been dismissed, the facts relating to its dismissal are to be stated in the fresh Petition (see Form above); and the Petitioner must obtain from the Commissioners in Lunacy a Copy of the Statement sent to them of the reasons for its dismissal, and present this copy with his Petition. The Reception Order (which will not remain in force for more than seven days after its date), the Petition, the Statement of Particulars, and the Medical Certificates must be sent to the Superintendent or Proprietor of the Asylum, Hospital, or House where the Patient is to be received.

[Sidenote: (_a_) _Insert residence of patient._

(_b_) County, city, _or_ borough, _as the case may be._

(_c_) _Insert profession or occupation, if any._

(_d_) _Insert the place of examination, giving the name of the street with number or name of house, or should there be no number, the Christian and surname of occupier._

(_e_) County, city, _or_ borough, _as the case may be._

(_f_) _Omit this where only one certificate is required._

(_g_) A lunatic _or_ an idiot, _or_ a person of unsound mind.

(_h_) _If the same or other facts were observed previous to the time of the examination, the certifier is at liberty to subjoin them in a separate paragraph._

(_i_) _The names and Christian names (if known) of informants to be given, with their addresses and descriptions._

(_k_) _Strike out this clause in case of a patient whose removal is not proposed._

(_l_) _Insert full postal address._]

53 Vict. c. 5.--Sched. 2, Form 8.

CERTIFICATE OF MEDICAL PRACTITIONER

In the Matter of_________________________________________

of (_a_)_____________________________________________________

in the (_b_)_____________________ of_________________________

(_c_) _______________________________________________________

_______________________________________an alleged lunatic.

I, the undersigned, ______________________________________________
do hereby certify as follows:

1. I am a person registered under the Medical Act, 1858,
and I am in the actual practice of the medical profession.

2. On the_______________________ day of ________________ 19__
at (_d_) _______________________________________________
in the (_e_)___________________ of _____________________
_________________(separately from any other practitioner) (_f_)
I personally examined the said ___________________________________
and came to the conclusion that ____ he is (_g_) ____________
and a proper person to be taken charge of and detained under
care and treatment.

3. I formed this conclusion on the following grounds, viz.:--

(_a_) Facts indicating insanity observed by myself at the
time of examination (_h_), viz.:--
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

(_b_) Facts communicated by others (_i_), viz.:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

4. The said __________________________________________________
appeared to me to be[18]..................in a fit condition of
bodily health to be removed to an asylum, hospital, or licensed
house (_k_).

5. I give this certificate having first read the section of the
Act of Parliament printed below.

=Signed=____________________________________
of (_l_)_____________________________

=Dated= this __________ day of ________ 19__

[18] _Or_ not to be.

[Sidenote: Lunacy 8.

53 Vict. c. 5, ss. 4, 11, 16, 28, 29.]

_Extract from section 317 of the Lunacy Act, 1890._

Any person who makes a wilful misstatement of any material
fact in any medical or other certificate or in any statement or
report of bodily or mental condition under this Act, shall be
guilty of a misdemeanour.

[Sidenote: (_a_) A Justice for --, specially appointed under the Lunacy Act, 1890, _or_ the Judge of the County Court of --, _or_ the Stipendiary Magistrate for--

(_b_) _Address and occupation._

(_d_) _Name of petitioner._]

53 Vict. c. 5.--Sched. 2, Form 3.

ORDER FOR RECEPTION OF A PRIVATE PATIENT, TO BE MADE
BY A JUSTICE APPOINTED UNDER THE LUNACY ACT, 1890,
JUDGE OF COUNTY COURTS, OR STIPENDIARY MAGISTRATE

I, the undersigned _______________________________________________
being (_a_) _________________________________________________
__________________________________________________________________
upon the petition of _____________________________________________
of (_b_) ____________________________________________________
in the Matter of _________________________________________________
a person of unsound mind, accompanied by the Medical Certificates
of _______________________________________________________________
and ______________________________________________________________
hereto annexed, and upon the undertaking of the said (_d_)
__________________________________________________________________
to visit the said ________________________________________________
personally or by some one specially appointed by the said (_d_)
__________________________________________________________________
once at least in every six months while under care and treatment
under this Order, hereby authorise you to receive the
said _____________________________________________________________
as a patient into your Licensed House (_e_).

=And= I declare that I have [_or_ have not] personally
seen the said ____________________________________________________
before making this Order.

=Dated= this __________________ day of ________________ 19___

=Signed= (_a_) _________________________

_A Justice for _________________________________
appointed under the above-mentioned Act [or the
Judge of the County Court of_____________________
or a Stipendiary Magistrate_].

=Urgency Orders.=--Where it is urgent that an alleged lunatic (not a pauper) must be put under restraint as soon as possible, he may be received upon an _urgency order_, without petitioning a Judicial Authority, accompanied by a _statement of particulars_ and _one medical certificate_. The order should be made by the husband, wife, or a relative of the alleged lunatic; if this be not possible, the reasons must be stated. It may be signed before or after the medical certificate, and before or after a petition order has been made. If before, it must be noted in the petition; if after, a copy must accompany the petition. No person may sign an urgency order if under twenty-one years of age, and must have seen the alleged lunatic within two days before the date of the order.

The urgency order remains in force seven days from its date, during which period the procedure for a “Judicial Order on Petition” is carried out. If the petition has been presented and the order is for some reason or other deferred, then the urgency order remains in force. The medical examination for certification must have been made not more than two days before reception, and reasons must be given why “it is expedient” that the alleged lunatic should be put under control “forthwith.”

[Sidenote: (_a_) House, _or_ hospital, _or_ asylum, _or_ as a single patient.

(_b_) _Name of Patient._

(_c_) Lunatic, _or_ an idiot, _or_ a person of unsound mind.

(_d_) _Some day within two days before the date of the order._

(_e_) Husband, wife, father, father-in-law, mother, mother-in-law, son, son-in-law, daughter, daughter-in-law, brother, brother-in-law, sister, sister-in-law, partner, or assistant.

(_If not the husband or wife, or a relative of the patient, the person signing to state as briefly as possible_--1. _Why the order is not signed by the husband or wife, or a relative of the patient._ 2. _His or her connection with the patient, and the circumstances under which he or she signs._)

(_f_) Superintendent of ____ the ____ asylum, ____ hospital _or_ resident licensee of the ____ house (_describing the asylum, hospital, or house by situation and name_.)

Lunacy, Nos. 4 & 2.

(33 Vict. c. 5, s. 11.)]

53 Vict. c. 5.--Sched. 2.

FORM OF URGENCY ORDER FOR THE RECEPTION OF A
PRIVATE PATIENT, WITH MEDICAL CERTIFICATE
AND STATEMENT ACCOMPANYING URGENCY ORDER

Forms 4, 2, 8 and 9.

I, the undersigned, being a Person Twenty-one years of age,
hereby authorise you to receive as a Patient into your (_a_)
House (_b_) _________________________________________________
__________________________________________________________________
as a (_c_) __________________________________whom I last saw at
____________________________________________________________________
on the (_d_) __________________ day of_______________ 19____

I am not related to or connected with the Person signing
the Certificate which accompanies this Order in any of the
ways mentioned in the Margin. (_e_) Subjoined (_or_ annexed)
hereto is a Statement of Particulars relating to the said __________

(=Signed=) _____________________________________
_Name and Christian Name_ } _______________________________
_at Length_ } _______________________________
_Rank, Profession, or Occupation_ } _______________________
_(if any)_ } _______________________
_Full Postal Address_ _____________________________________
_How related to or connected_ } ___________________________
_with the patient_ } ___________________________

=Dated= this _______________ day of __________ 19____

STATEMENT OF PARTICULARS REFERRED TO IN THE
ANNEXED ORDER

_If any Particulars are not known,
the Fact is to be so stated._

(Where the patient is in the petition or order described
as an idiot, omit the particulars marked ►.)

The following is a Statement of Particulars } ____________________
relating to the said } ____________________

Name of Patient, with Christian Name } ___________________________
at length } ___________________________

Sex and Age __________________________

Married, Single, or Widowed ______________________________________

► Rank, Profession, or previous Occupation } _____________________
(if any) } _____________________

► Religious Persuasion ___________________________

Residence at or immediately previous } ___________________________
to the date hereof } ___________________________

► Whether First Attack ________________
Age on First Attack ________________

When and where previously under Care } ________________________
and Treatment as a Lunatic, Idiot, or } ________________________
Person of Unsound Mind } ________________________

► Duration of existing Attack ____________________________________

Supposed Cause ___________________________________________________

Whether subject to Epilepsy ______________________________________

Whether Suicidal _________________________________________________

Whether dangerous to Others, and in } ____________________________
what way } ____________________________

Whether any near Relative has been } _____________________________
afflicted with Insanity ... ... } _____________________________

Names, Christian Names, and full Postal } ________________________
Addresses of one or more Relatives } ________________________
of the Patient } ________________________

Name of the Person to whom Notice } _________________________
of Death to be sent, and full Postal } _________________________
Address, if not already given } _________________________

Name and full Postal Address of the } __________________________
usual Medical Attendant of the } __________________________
Patient } __________________________

=Signed= _________________________________________

When the Petitioner or person signing an Urgency Order is =NOT=
the person who signs the Statement, add the following particulars
concerning the person who signs the Statement.

Name, with Christian name at length ______________________________

Rank, profession, or occupation (if any) _________________________

How related to or otherwise connected } __________________________
with the patient } __________________________

[Sidenote: (_a_) _Insert residence of patient._

(_b_) County, city, _or_ borough, _as the case may be._

(_c_) _Insert profession or occupation, if any._

(_d_) _Insert the place of examination, giving the name of the street, with number or name of house, or should there be no number, the Christian and surname of occupier._

(_e_) County, city, _or_ borough, _as the case may be._

(_f_) _A lunatic_, an idiot, _or_ a person of unsound mind.

(_g_) _If the same or other facts were observed previous to the time of the examination, the certifier is at liberty to subjoin them in a separate paragraph._

(_h_) _The names and Christian names (if known) of informants to be given, with their addresses and descriptions._

Lunacy, Nos. 8 & 9.

(53 Vict. c. 5, ss. 11, 28, 29, 32 and 33.)]

53 Vict. c. 5.--Sched. 2, Form 8.

CERTIFICATE OF MEDICAL PRACTITIONER

In the Matter of _________________________________________________
of (_a_) ____________________________________________________
in the (_b_)________________________ of _____________________
(_c_) _______________________________________________________
an alleged lunatic.

I, the undersigned _______________________________________________
do hereby certify as follows:--

1. I am a person registered under the Medical Act, 1858,
and I am in the actual practice of the medical profession.

2. On the ________________ day of ___________________ 19 ______
at (_d_) ______________________________________________
in the (_e_) ________________ of ______________________
I personally examined the said _____________________________
and came to the conclusion that ____ he is (_f_)_______
and a proper person to be taken charge of and detained under
care and treatment.

3. I formed this conclusion on the following grounds, viz.:--

(_a_) Facts indicating Insanity observed by myself
at the time of examination (_g_), viz.:--
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

(_b_) Facts communicated by others (_h_), viz:--
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

[Sidenote: (_i_) _If an urgency certificate is required, it must be added here.--Form No. 9._

(_k_) _Strike out this clause in case of a private patient whose removal is not proposed._

(_l_) _Insert full postal address._

53 Vict. c. 5.--Form 9.]

(_i_) STATEMENT ACCOMPANYING URGENCY ORDER

I certify that it is expedient for the welfare of the said ________
_______________________ (_or_ for the public safety, _as the
case may be_) that the said ____________________________________
should be forthwith placed under care and treatment.

My reasons for this conclusion are as follows: ____________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

4. The said _______________________________________________________
appeared to me to be [‡ _____________] in a fit condition of bodily
health to be removed to an asylum, hospital, or licensed house
(_k_). (‡) Or not to be.

5. I give this certificate having first read the section of the Act
of Parliament printed below.

=Dated= this ________________ day of _________________________
One thousand nine hundred and ______________

(=Signed=) _____________________________
of (_l_) _____________________________

_Extract from section 317 of the Lunacy Act, 1890._

Any person who makes a wilful misstatement of any
material fact in any medical or other certificate,
or in any statement or report of bodily or mental
condition under this Act, shall be guilty of a
misdemeanour.

=Orders after Inquisition.=--This constitutes a legal investigation as to whether or not a person is capable of managing his or her own affairs, and whether restraint is necessary. It is conducted before a judge, with a jury if the alleged lunatic demand one, unless the judge is satisfied by personal examination that the lunatic is not mentally competent to understand the demand for a jury. In such a case the medical man is only concerned as a witness.

According to circumstances the alleged lunatic may be kept under restraint, or remain at liberty with the control of his or her affairs under a “Committee of Estate”; or, if declared sane, set free and with control of his estate.

=Summary Reception Orders.=--When a lunatic is not under proper control, and if without relations or friends, and there be no one who will sign a petition for detention, or when a lunatic is uncared for, cruelly treated, and is found so by a medical practitioner, his duty is to inform a constable, relieving officer, or overseer of the parish of the fact. The official will then make a statement on oath to a Judicial Authority, who will direct two medical practitioners to make the necessary examinations, and if satisfied he will issue an order for the removal of the individual to an asylum. The procedure followed will then be the same as for a “petition for reception.” Under a summary reception order the Judicial Authority may place the person under the care of a relation or friend, or the visitors of the asylum in which the person is intended to be, or is placed.

=Lunatics Wandering at Large.=--Every constable, relieving officer, or overseer of a parish who knows of a person, whether pauper or not, who is deemed to be a lunatic and wandering at large, shall apprehend and take such person before a Justice, or if the Justice receive information on oath, he may have the person apprehended and brought before him. The Justice has the person medically examined, and if certified a lunatic to the satisfaction of the Justice, he may issue an order for detention; if the medical man certify that the person is not fit for removal, the removal is postponed until the person is certified fit for it.

The above proceedings are not necessary if it be considered a matter of public safety and for the good of the alleged lunatic that immediate detention be carried out. The constable, relieving officer, or overseer of the parish may remove such person to the workhouse of the union in which the person is, and detain him for not more than three days. Before the expiration of that time the necessary proceedings under the Lunacy Act must be taken.

=Reception Order by two Commissioners.=--Any two or more Commissioners in Lunacy may visit a pauper lunatic or an alleged lunatic not detained in a workhouse or lunatic asylum, and if satisfied after certification by a medical man that the person is a lunatic, order removal to an asylum.

=Pauper Lunatics.=--A medical officer of a Poor Law Union who has knowledge that a pauper within his district is alleged to be a lunatic, shall notify the relieving officer or overseer of the parish where the pauper resides of the fact, who within three days shall notify a Justice, who will interview the alleged lunatic and call in a medical practitioner to examine and certify. If the Justice be satisfied that the person be a lunatic, he makes an order for removal to an asylum. One medical certificate only is necessary.

=Escape of Lunatics.=--An escaped lunatic may be retaken at any time within fourteen days without a fresh order.

=Discharge of Lunatics.=--The reception order remains in force for periods of one, two, and three years, and then for periods of five years. At the end of any of these periods the Lunacy Commissioners may continue the detention of the lunatic, if satisfied by certification from the medical man of the institution, or the usual medical attendant of the lunatic, that the patient remains of unsound mind and further detention is necessary.

The petitioner of the reception order may request the discharge of a patient. The discharge may be refused if the medical man in charge certifies the lunatic dangerous and unfit to be at large, unless two of the visitors to the asylum or the Commissioners visiting the asylum or house give their consent in writing.

Two Commissioners--one medical, the other legal--may order the discharge of any patient.

When a patient recovers, the medical attendant of the institution notifies this to the petitioner or person responsible for the payment on account of the patient. Should the patient not be removed within seven days of such notice, the patient may be discharged “forthwith.”

PROCEDURE IN SCOTLAND

Idiots and imbeciles under eighteen years of age may be received into training schools without the legal procedure which obtains in England and Wales. They are sent to these institutions as lunatics, however, under the usual legalities, in order that the Government grant may be obtained. When over eighteen years of age, if sent to institutions other than training schools, they are classed as lunatics, and the necessary legal procedure is followed.

=Insane persons whose malady is not confirmed= may be cared for privately for a period not exceeding six months. The certificate of one medical practitioner only is required.

_Insane persons_, pauper or not, can be placed in an asylum by order of the Sheriff, by petition and two medical certificates. The inspector of the poor acts as petitioner for paupers.

In cases of urgency a _certificate of emergency_ from one medical practitioner is required, along with a request from the petitioner, to the superintendent of the asylum.

A person who is _prodigal_ or _facile_ can be restrained from alienating his property by guardians appointed by the Court.

When a lunatic is found to be incapable of administering his or her estate, the Court appoints a Committee of Estate.

PROCEDURE IN IRELAND

The procedure differs in pauper and private cases.

=Pauper patients, not dangerous.=--In order to detain such a pauper there must be a declaration of insanity and destitution, with the names and addresses and descriptions of two relatives of the person, given before a magistrate. A magistrate and a clergyman or poor-law guardian must certify that they have personally inquired into the case. One medical certificate is necessary. The applicant must remove the patient when called upon.

=Paying patients who are not dangerous=, for admission to a district asylum, are under more stringent regulations. A declaration that they are unable to pay the expenses necessary for support in a licensed house must be made before a magistrate; further, that there is no friend who can undertake this; and a statement of the length of time the patient has resided in the country. A magistrate and clergyman must certify that they have investigated the case. One medical certificate must be signed by two practitioners. A guarantee for the payment must be given, and also to remove the patient when called upon. The sanction of an inspector of lunatics must be given.

For admission into licensed houses, charitable institutions, and single care, an order by a relative or connection of the lunatic is required with two medical certificates, unless urgent, when one is sufficient, but a second must follow within fourteen days.

LIABILITIES OF PERSONS SIGNING LUNACY CERTIFICATES

A medical practitioner is bound to certify as to the sanity of a person. If, however, he undertakes to fill up the certificates necessary for the detention of an alleged lunatic, he becomes responsible to the authorities for the correctness of the certificates, and if he make a wilful misstatement of facts he is guilty of a misdemeanour. The medical practitioner may have an action brought against him by the lunatic when recovered or discharged. The most vindictive feelings may be entertained against the medical man. In such a case, if the medical man proves his “good faith” and the exercise of “reasonable care” in his examination and certification, he receives the protection of the Court.

LIABILITIES OF PERSONS RECEIVING INSANE PATIENTS

In the case of Nottidge _v._ Ripley and Nottidge, the Lord Chief Baron having been understood to intimate an opinion that no person ought to be so confined unless he is dangerous to himself or others, the Commissioners pointed out that the scope of the Lunacy Acts is not thus limited. They said:

“The object of these Acts is not, as your Lordship is aware, so much to confine lunatics, as to restore to a healthy state of mind such of them as are curable, and to afford comfort and protection to the rest. Moreover, the difficulty of ascertaining whether one who is insane be dangerous or not is exceedingly great, and in some cases can only be determined after minute observation for a considerable time.

“It is of vital importance that no mistake or misconception should exist, and that every medical man who may be applied to for advice on the subject of lunacy, and every relative and friend of any lunatic, as well as every magistrate and parish officer (each of whom may be called upon to act in cases of this sort), should know and be well assured that, according to law, any person of unsound mind, whether he be pronounced dangerous or not, may legally and properly be placed in a county asylum, lunatic hospital, or licensed house, on the authority of the preliminary order and certificates prescribed by the Acts.

“Upon the whole, it appears that the power to restrain and confine a lunatic is limited at common law to cases in which it would be dangerous, either as regards others or himself, for the lunatic to be at large; but that the power to place and detain a lunatic in a registered hospital or licensed or other house, under an order and medical certificates duly made and obtained in accordance with the Lunacy Acts, is not so limited.”

The terms of the Lunacy Act, 1890, are as follows:

“Subject to the exceptions in this Act mentioned a person
shall not be received or detained as a lunatic, as a single
patient, unless under a reception order by a judicial
authority.” “Every person who, except under the provisions
of the Act, receives or detains a lunatic or an alleged
lunatic in an institution for lunatics, or for payment takes
charge of, receives to board or lodge, or detains a lunatic
or alleged lunatic in an unlicensed house, shall be guilty
of a misdemeanour, and in the latter case shall also be
liable to a penalty not exceeding fifty pounds.” “Except
under the provisions of this Act, it shall not be lawful for
any person to receive or detain two or more lunatics in any
house, unless the house is an institution for lunatics or a
workhouse.” “Any person who receives or detains two or more
lunatics in any house except as aforesaid shall be guilty of
a misdemeanour.”

It is therefore unlawful to receive a lunatic or alleged lunatic except by reception order. Only one can be received into a private house, and a reception order is required. No medical man should receive a lunatic into residence without the necessary reception order. All the statutory regulations are demanded for a single case, and the private house is subject to visitation and inspection.

It is also important to remember that if any one receive a person not insane at the time, but who subsequently becomes insane, he renders himself liable to prosecution, unless he procure the necessary medical certificates and order (R. _v._ Wilkins).

=Is a Lunatic a competent Witness?=--Mr. Fitzjames Stephen maintains (_Criminal Law_) that madmen are competent witnesses in relation to testimony as in relation to crime. If they understand the nature of an oath, and the character of the proceedings in which they are engaged, they are competent witnesses whatever be the nature or degree of their mental disorder. An idiot shall not be allowed to give evidence (Co. Litt. 6 b; Gilb. Ev. 144); a lunatic during a lucid interval may do so (_Id. Com. Dig. Testm._ {A}). When a lunatic is tendered as a witness, it is for the judge to examine and ascertain whether he is of competent understanding to give evidence, and is aware of the nature and obligation of an oath; if satisfied that he is, the judge should allow him to be sworn and examined (R. _v._ Hill, 2 Den. 255; 20 L.J. [M.C.] 222).

=The Civil Rights of Lunatics.=--If an individual be suffering from such mental disease as to render him incompetent to manage his own affairs, the law steps in to protect him and his property from injury. But the power so used does not necessarily imply that he is deprived of his personal freedom, but merely such restraint as is necessary for his protection.

Many lunatics, under the protection of the Court, live in their own houses with large establishments. A person so protected by the law is said to be subject to an “interdiction.” In these cases a commission is usually granted by the Court of Chancery, and a writ known under the name of “_de lunatico inquirendo_” issued, after certain legal matters of detail are settled, and affidavits from medical men certifying to the insanity of the party have been filed.

The tests of insanity in these cases differ from those required in criminal cases, where the knowledge of right from wrong is imperatively demanded. The mental defect must not be the result of ignorance or want of education, and at one time commissions were only issued when it was shown that lunacy and idiocy alone existed, imbecility or mere weakness of mind not being deemed sufficient to deprive a man of his civil rights, or to place him under the protection of the Court.

To so great an absurdity did this lead, that the man suffering from a delusion sufficient to be comprehended under the legal term “lunacy” was protected, whereas the feeble-minded were left without interference, though needing it more. The cost of these commissions sometimes reached almost fabulous sums. The expense has been somewhat lessened by recent enactments, and the process simplified--the Lord Chancellor having it in his power to direct an inquiry before two Commissioners, thus dispensing with a jury. (See the 16 and 17 Vict. c. 70, and 25 and 26 Vict. c. 86.)

In Scotland, however, the law is far more simple. The cognition proceeds on a _brieve_ or writ addressed to the Lord President of the Court of Session, and directs him to inquire “whether the person sought to be cognosced is insane, who is his nearest agnate, and whether such agnate is of lawful age.” “And such person shall be deemed insane if he be furious or fatuous, or labours under such unsoundness of mind as to render him incapable of managing his affairs.” “The trial is before a judge of the Supreme Court and a special jury. If the insanity be proved, the nearest agnate--relation by the father‘s side--is by law entitled to the guardianship.” No one not a near relative can institute these proceedings.

In Scotland also, the trial by jury may be avoided by applying by petition to the Court of Session for the appointment of a judicial factor or _curator bonis_. Of this appointment the alleged lunatic is informed, which, if he please, he may oppose; medical evidence is received, and on this the Court rests its decision--the usual course being to remit the case to some competent person to make inquiry, take evidence, and report. The Commissioner is usually the Sheriff.

=Examination of the Insane.=--A few words of caution need here be said. Medical men will consult their own dignity and that of their profession by remembering that in cases of alleged insanity, as in fact in all other cases when their opinion is sought, they are not justified in taking sides. Their evidence will be the more valuable in proportion to the care they take in examining into the facts of the case, and the good sense and judgment shown in their examination of the patient. To distinguish between the mistakes, the result of ignorance and want of education, and those the result of a feeble mind, is of primary importance. It is no sign of insanity in an uneducated farmer that he knows not the _pons asinorum_. All cases should be tested by considering the surroundings and possible degree of culture of a person placed under like conditions as the party under examination. Has he shown himself capable of an average amount of culture? or is his mental condition inferior to what one might legitimately expect under the influences to which he has been subjected? The medical examiner should also direct his attention to this important point, setting aside all legal and medical theories of insanity, viz.--“Is the case of _such mental disorder_ as to create _an incapacity for managing affairs_.”

TESTAMENTARY CAPACITY

A medical practitioner may be called upon to give evidence as to the capacity of a testator to make a valid will. An ordinary person witnessing a will does so to fact only, but if a medical man do so it implies that he was of the opinion that the testator was fit to make a will and of a sound and disposing mind. In making an examination of a person for fitness to make a will, the medical man must endeavour to find out if the testator understands the nature of his action, and all the details associated with it; also if he knows the nature and amount of his property, and the claims or otherwise of those who may become beneficiaries under it. Further, has he such a delusion as may influence his will in disposing of his property, and bring about a disposal of it which, if the mind had been sound, would not have been made.

A person may have a delusion or delusions without interfering with the making of a will. If the “disposing mind” be left intact, testamentary capacity is upheld. In severe illness and old age the mind may be so disturbed, without true insanity being present, that a person is rendered incapable of making a will. In all such cases the medical man should be sure of his ground before granting, if requested, that the patient is capable or otherwise. It is a good plan, when examining a patient as to testamentary capacity, to have the will produced, and privately read it out to the person and ask if it be correct, then to have the person repeat the dispositions of the will, and see if they coincide with the contents of the document.

People who are aphasic may make wills which are valid. Difficulties arise in cases of sensory aphasia.

RESTRAINT OF HABITUAL DRUNKARDS

An habitual drunkard, as defined by law, is “a person who, not being amenable to any jurisdiction in lunacy, is notwithstanding, by reason of habitual intemperate drinking of intoxicating liquor, at times dangerous to himself or herself, or to others, or incapable of managing himself or herself or his or her own affairs.”

Before placing such a person under restraint in a licensed retreat the person‘s consent must be obtained. The patient must make an application to a Justice of the Peace, and supported by a declaration from two persons stating that the applicant is an habitual drunkard within the meaning of the Act. If the justice be satisfied, he can make out an order for detention. The order is valid for any time mentioned in the application not exceeding two years. The patient can be detained, forcibly if necessary, and if escaped may be arrested and taken back.