The ethics of involuntary psychiatric treatment: a study into the social and moral structures through which we construct illness and the justifications for involuntary intervention

This dissertation takes the form of a series of papers which, if taken together, study the role of patient autonomy in involuntary psychiatric treatment. This is not an argument 'for' or 'against' involuntary psychiatric treatment. My reasoning supports the status quo insomuch as involuntary hospitalisation and treatment are sometimes warranted, with the greater moral question being that of when is involuntary treatment justified. That is, what moral framework should guide institutional policies on the use of involuntary treatment? I argue that the orthodox moral theory fails to adequately account for both the evaluative component of mental competence and the social and relational features of meaningful personal autonomy. These deficiencies in the underlying moral framework have forced psychiatrists and medical institutions to continually stretch formal criteria for intervention to the point where they have become ad hoc justifications for paternalism, in which bias can be embedded in a manner that is undetectable in individual cases, and impervious to effective challenge by individual patients.