Compulsory treatment in psychiatry

Vollmann, Jochen

doi:10.1007/s00115-013-3866-9

Cited by 24 publications

(4 citation statements)

References 30 publications

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“…In relation to the abovementioned distinction between informal and formal coercion, the absence of decision-making capacity should not facilitate the use of coercion ( 1 , 4 , 9 ). Indeed, an absence of decision-making capacity is necessary to use coercion but is not sufficient ( 1 , 4 , 9 , 10 , 17 , 18 , 29 – 32 , 74 , 75 , 77 , 81 , 86 , 89 , 91 , 105 , 137 ). Decision-making incapacity alone is not enough to coerce someone; paternalism and power abuse would appear ( 31 , 32 ).…”

Section: Resultsmentioning

confidence: 99%

Coercive Measures in Psychiatry: A Review of Ethical Arguments

et al. 2021

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Introduction: Coercion is frequent in clinical practice, particularly in psychiatry. Since it overrides some fundamental rights of patients (notably their liberty of movement and decision-making), adequate use of coercion requires legal and ethical justifications. In this article, we map out the ethical elements used in the literature to justify or reject the use of coercive measures limiting freedom of movement (seclusion, restraint, involuntary hospitalization) and highlight some important issues.Methods: We conducted a narrative review of the literature by searching the PubMed, Embase, PsycINFO, Google Scholar and Cairn.info databases with the keywords “coercive/compulsory measures/care/treatment, coercion, seclusion, restraint, mental health, psychiatry, involuntary/compulsory hospitalization/admission, ethics, legitimacy.” We collected all ethically relevant elements used in the author's justifications for or against coercive measures limiting freedom of movement (e.g., values, rights, practical considerations, relevant feelings, expected attitudes, risks of side effects), and coded, and ordered them into categories.Results: Some reasons provided in the literature are presented as justifying an absolute prohibition on coercion; they rely on the view that some fundamental rights, such as autonomy, are non-negotiable. Most ethically relevant elements, however, can be used in a balanced weighting of reasons to favor or reject coercive measures in certain circumstances. Professionals mostly agree that coercion is only legitimate in exceptional circumstances, when the infringement of some values (e.g., freedom of movement, short-term autonomy) is the only means to fulfill other, more important values and goals (e.g., patient's safety, the long-term rebuilding of patient's identity and autonomy). The results of evaluations vary according to which moral elements are prioritized over others. Moreover, we found numerous considerations (e.g., conditions, procedural values) for how to ensure that clinicians apply fair decision-making procedures related to coercion. Based on this analysis, we highlight vital topics that need further development.Conclusion: Before using coercive measures limiting freedom of movement, clinicians should consider and weigh all ethically pertinent elements in the situation and actively search for alternatives that are more respectful of patient's well-being and rights. Coercive measures decided upon after a transparent, carefully balanced evaluation process are more likely to be adequate, understood, and accepted by patients and caregivers.

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Section: Resultsmentioning

confidence: 99%

Coercive Measures in Psychiatry: A Review of Ethical Arguments

et al. 2021

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“…Viele Abteilungen versuchen, eine Versorgung mit weitgehend offenen Stationen und einem Minimum an Zwangsmaßnahmen zu leisten [14]. Eine Abrüstung stellen in der Praxis auch die gesetzgeberischen Einschränkungen für die medikamentöse Zwangsbehandlung dar [15]. Sie haben zu einem Anstieg aggressiver Vorfälle und freiheitseinschränkender mechanischer Zwangsmaßnahmen geführt.…”

Section: Vergleich Von Ap Und Fpunclassified

Zusammenhänge des Stationsklimas mit objektiven Rahmenbedingungen psychiatrischer Stationen

Schalast

Sieß

2017

Psychiat Prax

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The EssenCES, originally catered for forensic settings, proved to be useful to characterize general psychiatric wards. A number of suggestions regarding relevant setting conditions are clearly confirmed (like staffing level; open vs. closed wards). Remarkably, staff experience a higher level of on forensic than on general psychiatric wards. and are rated higher on general psychiatric wards. Heterogeneity of patients (vs. specialization of wards) is not positively related to climate characteristics; staff experiences less on non-specialized wards.

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“…26 Psikiyatri kliniklerinde özerkliğin yani hasta bireyin, kendi kaderini tayin etmesinde aşağıdaki kriterler dikkate alınır. 27  Bilgiyi anlama  Muhakeme yeteneği  Bir ruhsal bozukluk/sorunu (hastalığa ilişkin içgörü) olduğunu fark edebilme  Tedavi seçenekleri hakkında bilgi sahibi olma  Karar verme ve ifade etme becerisi.…”

Section: Temel Etik Ilkelerin Normatif Değerlendirilmesiunclassified

Psychiatric Care in the Normative Ethics

Bag¹

2021

Turkiye Klinikleri J Med Ethics

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Compulsory treatment in psychiatry

Abstract: The ethical analysis of the new law on compulsory treatment in Germany shows chances for improvement of clinical psychiatric practice as well as normative problematic regulations and fields of conflicts.

Cited by 24 publications

References 30 publications

Coercive Measures in Psychiatry: A Review of Ethical Arguments

Coercive Measures in Psychiatry: A Review of Ethical Arguments

Zusammenhänge des Stationsklimas mit objektiven Rahmenbedingungen psychiatrischer Stationen

Psychiatric Care in the Normative Ethics

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