title: The importance of least restrictive care: the clinical implications of a recent High Court decision on negligence.
abstract: OBJECTIVE
  This paper aims to explain the meaning and implications for practice of the High Court of Australia's finding in the negligence case, Hunter and New England Local Health District v McKenna [2014] HCA 44.
  
  
  METHODS
  The facts of the case and the law of negligence are reviewed before reporting the Court's decision.
  
  
  RESULTS
  The High Court found that the obligation upon doctors to provide the least restrictive option for care that was imposed by the, then applicable, Mental Health Act 1990 (NSW) was inconsistent with an obligation that might otherwise be imposed by a common law duty to have regard to the interests of those with whom a psychiatric patient may come into contact if not detained.
  
  
  CONCLUSIONS
  The Court's finding underlines the importance of clinicians documenting their clinical reasoning around why their negotiated management plan was the option least restrictive of the patient's freedom and most protective of his or her human rights.
authors.affiliation: Consultation-Liaison Psychiatrist and Clinical Senior Lecturer, Discipline of Psychiatry and the Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia christopher.ryan@sydney.edu.au.
authors.forename: Christopher James
authors.initials: CJ
authors.lastname: Ryan
authors.affiliation: Lecturer, Sydney Law School and the Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia.
authors.forename: Sascha
authors.initials: S
authors.lastname: Callaghan
authors.affiliation: Conjoint Senior Lecturer, School of Psychiatry, University of NSW, Sydney, NSW, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Large
mesh_terms: D000328:Adult; D001315:Australia; D006801:Humans; D007883:Legislation, Medical / Q000941:ethics*; D008318:Malpractice / Q000331:legislation & jurisprudence*; D008603:Mental Health / Q000331:legislation & jurisprudence*
keywords: documentation; jurisprudence; malpractice; negligence; risk assessment