[Compulsory hospital admission - coercive measures in medical care]. 2009

Diana Meier-Allmendinger
Ambulatorium Klinik Schützen, Aarau. diana.meier@klinikschuetzen.ch

Any coercive medical intervention is a massive curtailment of the affected person's freedom that is in direct contradiction to their right to self-determination. This is why any such intervention must be laid on a solid legal and ethical foundation. Any decision to commit a person against their will for medical care will have to be made with due regard for both the institution's medical duty and society's interest in public safety. Any such decision must also involve careful consideration of whether the individual concerned is at acute risk of harming or injuring themselves or others as a result of their mental condition. Involuntary committal may be perceived as extremely insulting by the person concerned, who may feel that their right of self-determination has been violated; and at least for a limited period it will inevitably make them feel that they are not being treated like or regarded as an adult. Hence, the following ethical questions arise: Is it justified to suspend an individual's right of self-determination - if only in terms of their place of residence - by committing them for medical treatment and care? And how can such coercive committal be reconciled with the ethical medical principles of autonomy, beneficence, justice and non-maleficence? There are no stock answers or checklist answers to these questions. Whether a committal is warranted must ultimately be decided on a case-by-case basis by thoroughly assessing, weighting and comparing the various principles and considerations involved.

UI MeSH Term Description Entries
D007326 Institutionalization The caring for individuals in institutions and their adaptation to routines characteristic of the institutional environment, and/or their loss of adaptation to life outside the institution. Institutionalized Persons,Institutionalizations,Institutionalized Person,Person, Institutionalized,Persons, Institutionalized
D010344 Patient Advocacy Promotion and protection of the rights of patients, frequently through a legal process. Patient Ombudsmen,Patient Representatives,Clinical Ombudsman,Patient Ombudsman,Advocacy, Patient,Ombudsman, Clinical,Ombudsman, Patient,Ombudsmen, Patient,Patient Representative,Representative, Patient,Representatives, Patient
D010817 Physician-Patient Relations The interactions between physician and patient. Doctor-Patient Relations,Doctor Patient Relations,Physician Patient Relations,Physician Patient Relationship,Doctor Patient Relation,Doctor-Patient Relation,Physician Patient Relation,Physician Patient Relationships,Physician-Patient Relation,Relation, Doctor Patient,Relation, Doctor-Patient,Relation, Physician Patient,Relation, Physician-Patient,Relations, Doctor Patient,Relations, Doctor-Patient,Relations, Physician Patient,Relations, Physician-Patient,Relationship, Physician Patient,Relationships, Physician Patient
D010818 Practice Patterns, Physicians' Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided. Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D003068 Coercion The use of force or intimidation to obtain compliance.
D003134 Commitment of Mentally Ill Legal process required for the institutionalization of a patient with severe mental problems. Outpatient Commitment,Commitment, Outpatient,Mentally Ill Commitments
D003695 Delivery of Health Care The concept concerned with all aspects of providing and distributing health services to a patient population. Delivery of Dental Care,Health Care,Health Care Delivery,Health Care Systems,Community-Based Distribution,Contraceptive Distribution,Delivery of Healthcare,Dental Care Delivery,Distribution, Non-Clinical,Distribution, Nonclinical,Distributional Activities,Healthcare,Healthcare Delivery,Healthcare Systems,Non-Clinical Distribution,Nonclinical Distribution,Activities, Distributional,Activity, Distributional,Care, Health,Community Based Distribution,Community-Based Distributions,Contraceptive Distributions,Deliveries, Healthcare,Delivery, Dental Care,Delivery, Health Care,Delivery, Healthcare,Distribution, Community-Based,Distribution, Contraceptive,Distribution, Non Clinical,Distributional Activity,Distributions, Community-Based,Distributions, Contraceptive,Distributions, Non-Clinical,Distributions, Nonclinical,Health Care System,Healthcare Deliveries,Healthcare System,Non Clinical Distribution,Non-Clinical Distributions,Nonclinical Distributions,System, Health Care,System, Healthcare,Systems, Health Care,Systems, Healthcare
D005858 Germany A country in central Europe, bordering the Baltic Sea and the North Sea, between the Netherlands and Poland, south of Denmark. The capital is Berlin.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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