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

Craig Edwards

Research output: ThesisDoctoral Thesis

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Abstract

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.
Original languageEnglish
QualificationDoctor of Philosophy
Publication statusUnpublished - 2012

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Illness
Justification
Involuntary
Hospitalization
Paternalism
Moral Theory
Psychiatrists
Patient Autonomy
Personal Autonomy

Cite this

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title = "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",
abstract = "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.",
keywords = "Mental illness, Bioethics, Liberalism, Preventative detention, Personhood, Involuntary treatment, Psychiatry, Ethics",
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AB - 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.

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KW - Bioethics

KW - Liberalism

KW - Preventative detention

KW - Personhood

KW - Involuntary treatment

KW - Psychiatry

KW - Ethics

M3 - Doctoral Thesis

ER -