The duty to safeguard adults from abuse

Policies and procedures for ‘adult safeguarding’ aim to protect adults against the harm posed to them by other individuals. In England, safeguarding adults from abuse is a public duty, and psychiatrists have an important role to play in upholding this duty through their involvement in this process. Here, we outline ethical, legal and social issues raised by current procedures for adult safeguarding in England and consider proposals for policy reform alongside parallel developments in the law in Scotland. Addressing these issues adequately involves (a) clarifying who will require the support of safeguarding services, (b) defining the nature of the putative harm they face, (c) determining which interventions are justifiable, and (d) ascertaining the circumstances in which these interventions can be initiated. In line with other recent developments in mental health and mental capacity law, the major challenge facing the development of adult safeguarding policy and practice is to find an appropriate balance between protection and empowerment.