Medico-Legal Responsibilities within NIMH, Sri Lanka

With regard to the above subject, attention is drawn to the Ministry of Health General Circular NO:01-102002 & General Circular NO:01-05-2003 as well as the responsibilities of state officers stipulated in the Code of Criminal Procedure in Sri Lanka as well as guidelines issued by Sri Lanka Medical Council.

1. The Psychiatric Case Sheet (H8) and the BHT that is attached with it is a special medico-legal document that may be produced before the Courts & other Legal Officers for many purposes. As such much care should be given to document your findings and incidents very clearly in the BHT.

2. As per the existing NIMH policies & guidelines, all admitting officers & ward nursing officers are reminded about the importance of documenting all existing injuries of patients upon admission to

NIMH in detail in the BHT and the injury surveillance forms.

3. All incidents that result in physical injury to a patient must be documented clearly and in detail in the

BHT & informed to the Director.

4. If a patient complains of any harm done to him/her that has legal implications it is the responsibility of the medical staff to initiate the review of the patient urgently by the Consultant JMO after a MLEF is issued by the police.

5. The medical staff must be mindful of reporting any suspicious injury to a patient that may be due to possible assault/ torture while being admitted at NIMH.

6. Any incident of a patient when reported to the Director if found to be suspicious of a criminal act, it will be directed to be referred to police & JMO, after discussing with the relevant Consultant.

7. Incidents that are part of the therapeutic process which may have the need for the patients to be subdued and restrained physically to prevent self-harm, harm to others or absconding are considered as part of the involuntary treatment process under the Mental Diseases Ordinance. Such incidents should only be reported to the Director and for Clinical Governance Review through the Quality

Management Unit.