The involuntary commitment and treatment of mentally ill persons

Abstract

Some persons who are mentally ill and refuse treatment constitute a threat to themselves and/or others. Many psychiatrists, psychologists and jurists believe that society has only two ways of dealing with such individuals: it can involuntarily hospitalize these people for an indefinite amount of time and attempt to ‘cure’ them, or it can outlaw their behavior and incarcerate. In this essay I argue that neither of these options is morally defensible, and that it is far preferable when dealing with mentally ill persons who threaten either themselves or others to pursue a course of action which combines determinate sentencing with involuntary treatment. In developing my argument I proceed as follows. First, I consider the major justifications for the involuntary civil commitment of mentally ill persons and show that none is sound. Next, I argue that the only acceptable justification for denial of a mentally ill person's liberty is that he has broken some criminal law. Finally, I contend that involuntary hospitalization and treatment of some prisoners may be morally acceptable, but only when certain safeguards have been assured. Chiefly: (1) the prisoner must be judged to be incompetent to make an informed decision concerning treatment, and (2) the prisoner must serve the sentence imposed upon him by law, i.e. he cannot be forced to undergo treatment beyond the limit of his sentence, nor may he be released early because he is considered ‘cured’.