Selva Ramasamy KC (QEB Hollis Whiteman) and Deepika Raino (Brabners Solicitors) were invited to speak at a medico-legal seminar convened by the National MMSA (Medication to Manage Sexual Arousal) Prescribers Network.

Selva and Deepika had been invited to address the topic of “Public Interest Disclosures for Doctors”, with a particular focus on disclosure relating to sexual offending and risk.

The Medical Management of Sexual Arousal (MMSA) programme was introduced in 2014 in order to facilitate the provision of antilibidinal medication to those who would benefit, and to provide support for doctors in doing so. The prescription of antilibidinal medication to men who have committed sex offences has a long and at times controversial history. In some jurisdictions it can be a mandatory condition of release from prison, in effect making doctors agents of social control. Even outside legal settings, international prescribing protocols tend to focus on risk management rather than clinical need. A different approach has been taken in the UK, however, where prescribing is driven by medical considerations, and is on a voluntary basis.  

The National MMSA Prescribers Network provides a forum to allow doctors who practise in this field to share views and discuss developments.

For doctors (particularly psychiatrists) who provide MMSA treatment, difficulties can arise when a patient discloses information which indicates a risk of serious crime or serious harm – how is the doctor to balance their duty of confidentiality to the patient with their duty to protect the public?

Selva and Deepika’s talk set out the relevant legal principles and professional guidance for those who have to consider this difficult balance. They also provided case studies to demonstrate how the law and guidance might be applied in practice.

Selva and Deepika are grateful to Dr Rebekah Bourne (Consultant Forensic Psychiatrist, Chair of the National MMSA Prescribers Network) and Dr Bernard Chin (Consultant Forensic Psychiatrist) for their invitation to speak at this event.