Abstract
Compulsory interventions severely restrict constitutional rights of the patients. They are exceptional measures only to be considered under strict and clearly defined ethical and juridical conditions. They do confront mental health professionals with difficult questions challenging their individual professional identity as well as the identity of psychiatry in general. This complex field is discussed in reference to the conceptual history of psychiatry, to different contemporary approaches to the notion of autonomy, and to three ethically demanding issues: autonomy and care, psychiatry and society, personhood and interpersonal relations. Engaging open mindedly in these debates may be cumbersome for psychiatry, but will yield a substantial return, particularly regarding its identity and acceptance by society.
Highlights
The issue of compulsory interventions in psychiatry is usually regarded as a mainly ethical and practical topic
Two different epistemological levels are distinctively intertwined: the theoretical level reflecting upon the “object” of psychiatric work in therapeutic or research activities on the one hand, and the practical level focusing on how psychiatric services can be optimally organized within the competing demands of being effective, adequate, and economically justifiable1 on the other hand
Any therapist will try hard to build a therapeutic relationship even under the difficult, if not paradoxical, conditions of compulsory interventions. This directly alludes to the self-understanding of psychiatric professionals and, more general, to the identity of psychiatry
Summary
Compulsory interventions severely restrict constitutional rights of the patients They are exceptional measures only to be considered under strict and clearly defined ethical and juridical conditions. They do confront mental health professionals with difficult questions challenging their individual professional identity as well as the identity of psychiatry in general. This complex field is discussed in reference to the conceptual history of psychiatry, to different contemporary approaches to the notion of autonomy, and to three ethically demanding issues: autonomy and care, psychiatry and society, personhood and interpersonal relations.
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