Dr Irwin Pakula, as director of Illawarra Psychiatric Services, spoke from the viewpoint of one who has to deal with acute cases, where the patient lacks such insight into his or her situation that consent and instructions often cannot be considered at least in the first instance. These are difficult and tragic cases, often requiring extreme measures. By contrast, Geoff Beatson, as a disability support worker, advocated a model which promoted giving an intellectually disabled person the 'dignity of risk' as opposed to a more protective 'duty of care' model. Mr Beatson expressed confidence that with careful, patient communication, such a client could often understand the consequences of certain instructions and make a sensible decision. Mr Beatson emphasised the importance of getting feedback from the client to make sure that communication has been understood.
Support groups are often available to assist lawyers in communicating with such clients.
The issues that came out of this seminar were in many cases difficult to the point of being insoluble. However, many people have expressed an interest in being involved in a discussion group or network to give support to lawyers with such dilemmas. Information and shared experience must go a long way in helping to solve individual problems. These are important problems on which continuing work is needed. The Law Society of New South Wales is the professional association for the solicitors branch of the legal profession in the State of New South Wales, Australia.