Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Brendan Kelly, University of Dublin,
- Second opponent: Professor Geir Fagerfjord Lorem, UiT - The Arctic University of Norway,
- Third opponent: Professor Linda Gröning, University of Bergen,
- Fourth member and chair of the evaluation committee: Professor Unn Kristin Hansen Haukvik, University of Oslo
Chair of the Defence
Professor emerita Ragnhild Hellesø, University of Oslo
Principal Supervisor
Professor Reidar Pedersen, University of Oslo
Summary
This thesis explores the introduction of a capacity-based mental health law in Norway at the intersection of mental healthcare, law, and ethics. In 2017, comprehensive amendments to the Norwegian Mental Health Care Act introduced lack of decision-making capacity as an additional legal criterion for involuntary care and treatment. These amendments aimed to strengthen patient autonomy and reduce involuntary care and treatment rates.
Based on semi-structured interviews and focus groups with purposively selected patients, families, health professionals, and lawyers in supervisory bodies in 2018 and 2022–23, the thesis uses qualitative methods to examine how these amendments were experienced, how assessments of decision-making capacity were conducted, and which factors influenced these assessments in practice.
The findings suggest that the 2017 amendments increased awareness of patient autonomy and improved patient involvement. At the same time, they may have contributed to altered admission and discharge thresholds and placed an increased burden on primary care and families. The quality of capacity assessments appeared to vary, reflecting limited assessment training and a need for stronger quality assurance. In practice, assessments could be influenced by resource availability, health professionals' values and practices, legal interpretations by supervisory bodies, and political signals from health authorities. Combined with broader developments since 2017, the findings indicate that inadequate implementation of the amendments may have contributed to more severely ill patients being admitted and a continued rise in involuntary care and treatment rates.
The thesis highlights the complexity of legal reform in health systems and the need to recognise the interplay between legal, service-related, and societal factors to ensure effective implementation of future health laws.
Additional information
Contact the research support staff.