It is unethical to physically force or coerce someone into treatment against their will if they are of sound mind and are mentally capable of making an informed decision. Suppose someone is not competent to make their own health decisions.
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Is it unethical to force a patient into treatment against his will?
Oct 03, 2013 · article continues after advertisement. Those who fare poorly are much less forgiving. Their outrage is always understandable and also is completely justified if the coercive treatment was ...
Is it ethical to force someone to do something?
Nov 26, 2012 · The power to force treatment — whether through the old-style commitment laws or the new-style “assisted outpatient treatment” laws — cannot be trusted to others to wield compassionately or as an...
Can reasonable force be used to force a patient to accept treatment?
It is important to be aware of unethical treatment practices that are present in parts of the recovery industry. These activities range from morally gray to outright illegal. Many of these practices stem from competitive pressure or opportunities where profit-seeking overtakes the mission of helping people in recovery. For some types of services, such as support groups and …
How do people appease their guilt by doing something unethical?
Consent to medical treatment is probably the most significant principle underlying the law relating to treatment of psychiatric patients. To force medical treatment upon a patient is likely to contravene the prohibition against inhuman and degrading treatment under the Protection of Human Rights Act 1993, which was enacted in India on 8 January 1994, to provide for the …
Is it ever ethical to treat someone who refuses treatment?
Competent patients have a right to refuse treatment. This concept is supported not only by the ethical principle of autonomy but also by U.S. statutes, regulations and case law. Competent adults can refuse care even if the care would likely save or prolong the patient's life.Jul 5, 2017
Why is refusal of treatment an ethical dilemma?
In general, ethical tension exists when a physician's obligation to promote a patient's best interests competes with the physician's obligation to respect the patient's autonomy. “When you don't take your medication, you're more likely to get sick.”Jan 1, 2019
What ethical principle is violated with involuntary treatment?
encroachment on autonomy. It is because of concerns about such violations of a patient's autonomy that a civil process is required to ensure that the magnitude of beneficence to the patient justifies their loss of autonomy. from involuntary treatment.Nov 29, 2016
Does a patient have the right to refuse treatment?
Under federal law, the Patient Self-Determination Act (PSDA) guarantees the right to refuse life sustaining treatment at the end of life.Apr 16, 2015
What is refusal of treatment?
The right to refuse treatment applies to those who cannot make medical decisions for themselves, as well as to those who can; the only difference is how we protect the rights of people who cannot make decisions for themselves (see VEN's free handbook Making Medical Decisions for Someone Else).
Why do people reject medical advice?
People may want to refuse medical treatment for several reasons, including financial, religious, and quality of life. People are often within their rights to refuse treatment, but some exceptions exist.Feb 15, 2022
Is it ethical to force treatment?
United States, 2003). Forcing non-violent psychiatric patients to take medication against their will is an unethical practice and should be discontinued. For much of history, the treatments for mental illness have been coercive and inhumane.
Is coercive treatment ethical?
Coercion of capable* patients is acceptable ethically iff there is considerable risk to others due to their (physical or mental) health condition.
Is involuntary commitment ethical?
Although many patients believe involuntary treatment to be justified and necessary, follow-up studies suggest that a substantial number of patients disapprove of having been subjected to involuntary treatment, and negative experiences relating to restriction of freedom as well as violations of personal integrity are ...
What can you do if someone refuses medical treatment?
What to Do if Your Loved One Refuses to See a DoctorBe transparent and direct. ... Convince them that it's their idea. ... Make it a "double-checkup" ... Make the rest of the day as enjoyable as possible. ... Get someone who is an authority figure to help.Sep 23, 2015
What are the rights of a patient who refuses treatment?
In addition, there are some patients who do not have the legal ability to say no to treatment. Most of these patients cannot refuse medical treatment, even if it is a non-life-threatening illness or injury: 1 Altered mental status: Patients may not have the right to refuse treatment if they have an altered mental status due to alcohol and drugs, brain injury, or psychiatric illness. 6 2 Children: A parent or guardian cannot refuse life-sustaining treatment or deny medical care from a child. This includes those with religious beliefs that discourage certain medical treatments. Parents cannot invoke their right to religious freedom to refuse treatment for a child. 7 3 A threat to the community: A patient's refusal of medical treatment cannot pose a threat to the community. Communicable diseases, for instance, would require treatment or isolation to prevent the spread to the general public. A mentally ill patient who poses a physical threat to himself or others is another example.
What is a threat to the community?
A threat to the community: A patient's refusal of medical treatment cannot pose a threat to the community. Communicable diseases, for instance, would require treatment or isolation to prevent the spread to the general public. A mentally ill patient who poses a physical threat to himself or others is another example.
How can a patient's wishes be honored?
Another way for a patient's wishes to be honored is for the patient to have a medical power of attorney. This designates a person to make decisions on behalf of the patient in the event they are mentally incompetent or incapable of making the decision for themselves.
Can informed consent be bypassed?
In instances of an emergency situation, informed consent may be bypassed if immediate treatment is necessary for the patient's life or safety. 5 . In addition, there are some patients who do not have the legal ability to say no to treatment. Most of these patients cannot refuse medical treatment, even if it is a non-life-threatening illness ...
What is the meaning of refusing treatment at the end of life?
Choosing to refuse treatment at the end of life addresses life-extending or life-saving treatment. The 1991 passage of the federal Patient Self-Determination Act (PSDA) guaranteed that Americans could choose to refuse life-sustaining treatment at the end of life. 9
Can a parent refuse treatment?
Children: A parent or guardian cannot refuse life-sustaining treatment or deny medical care from a child. This includes those with religious beliefs that discourage certain medical treatments. Parents cannot invoke their right to religious freedom to refuse treatment for a child. 7 . A threat to the community: A patient's refusal ...
Who is Shereen Lehman?
Shereen Lehman, MS, is a healthcare journalist and fact checker. She has co-authored two books for the popular Dummies Series (as Shereen Jegtvig). Patients often face decisions on whether or not to put themselves through medical treatment. A recommended treatment might only provide comfort or it may speed healing.
Is mental health forced treatment?
Forced treatment for people with mental illness has had a long and abusive history, both here in the United States and throughout the world. No other medical specialty has the rights psychiatry and psychology do to take away a person’s freedom in order to help “treat” that person.
Is electroconvulsive therapy the same as shock therapy?
Kellner, MD unintentionally provides a perfect example of this double-standard in this article about why he believes electroconvulsive therapy (ECT, also known as shock therapy) shouldn’t be held to the same standards as FDA-approved drugs or other medical devices: Yes, ECT has adverse effects, including memory loss for some recent ...
How has the recovery industry changed?
Rapid changes in the industry have changed the recovery landscape by creating opportunities for individuals to earn greater profit than ever before. Several years ago, changes in requirements for private health insurers around treatment coverage began to attract more financially-driven individuals to the industry.
Is recovery unethical?
It is important to be aware of unethical treatment practices that are present in parts of the recovery industry. These activities range from morally gray to outright illegal. Many of these practices stem from competitive pressure or opportunities where profit-seeking overtak es the mission of helping people in recovery. For some types of services, such as support groups and counselors and therapists, ethical challenges are rarer due to the lower possibility of financial gain.
What is the Ulysses contract?
The name “Ulysses contract” refers to Homer’s example of Ulysses instructing his crew to bind him to the mast of his ship before they sailed past the irresistible sirens, and to ignore his requests for release. Thus he was able to enjoy the beautiful singing of the sirens without suffering the disastrous results that would normally have followed. Singh (2008), for example, has no hesitation in making such an advance directive permitting covert treatment being administered to him if the need arises.
Is covert medicine acceptable?
The practice of covert administration of drugs seems to be regarded as acceptable for both physical and psychiatric disorders as a last resort (Mason & McCall Smith, 1999) based on what the patient would have wanted and his ‘best interests’. However, what we need to be concerned about is the secrecy surrounding the practice and the lack of regulatory mechanisms, and also the absence of discussion within the treating team including the pharmacists regarding adverse side effects. Moreover, covert medication is often based on the judgment of a single professional, either the psychiatrist or the concerned nurse, and relatives may well be kept in ignorance. This disturbing picture is usually attributed to a culture of fear surrounding the practice in which written guidelines are lacking and concern about getting into wrangles with law drives the practice underground.
What was the Hargrave vs. Vermont case?
Vermont, grew out of a complaint filed in 1999 on behalf of Nancy Hargrave, a woman with a history of paranoid schizophrenia and multiple admissions to the Vermont State Hospital (Hargrave vs. Vermont, 2003). Hargrave had completed an advance directive–known in Vermont as a “durable power of attorney for health care,” or DPOA–in which she designated a substitute decision maker in case she lost competence and in which she refused “any and all anti-psychotic, neuroleptic, psychotropic, or psychoactive medications.” The major national law firm that represented Hargrave immediately filed suit to block the State of Vermont from overriding her advance directive should she ever again be involuntarily committed and obtained certification to represent the entire class of patients in similar situations. Hargrave’s target was Act 114, a 1998 Vermont statute that attempted to address the dilemma inherent in psychiatric advance directives. Although advance directives were intended to facilitate patients’ participation in treatment decisions, they have, as noted, the potential to prevent all treatment, even of patients who are ill enough to qualify for civil commitment under the prevailing dangerousness standards. To mitigate this prospect, the Vermont legislature allowed hospital (or prison) staff to petition a court for permission to treat an incompetent involuntarily committed patient, notwithstanding an advance directive to the contrary. Before the court could authorize nonconsensual administration of medication, it had to allow the terms of the patient’s advance directive to be implemented for 45 days. So a patient like Hargrave, who had declined all medications, would be permitted to go unmedicated for a 45-day period, after which the court could supercede the patient’s refusal of treatment.
Is it legal to treat someone without consent?
Legally, treatment without consent is permissible only where common law or statute provides such authority. The Indian Mental Health Act 1987, for example, states that being a voluntary patient, who has given his consent in writing or where such person (whether or not a voluntary patient) is incompetent by reason of minority or otherwise, to give valid consent, the guardian or other person competent to give consent on his behalf, has to give his consent in writing for treatment/ research. Akhtar et al. (1998) as well as Nambi (1996) have raised questions on issues related to not having any mention of ‘competence’, ‘consent’ ‘presumption of global incompetence’ and so on in the Act. These terms they believe are rightly to be dealt with in general laws and it is not necessary for us to dissect out all these issues for the day-to-day application of the Indian Mental Health Act. At this juncture it may be enough to revert to definitions, wherein a mentally ill person means a person who is in need of treatment; and when such a person is admitted as per Section 19, it is the psychiatrist’s duty to administer him treatment. The bonafides of treatment that are given could be made transparent by recording in the case files the reasons leading to a particular decision and also getting other colleagues involved in certain complex and important decisions. Even with Special Section 92 in the Act, to protect psychiatrists for actions taken in good faith, it is quite unwarranted for professionals to be unduly concerned about the risk of punishment as apprehended by Akhtar (1990).
What happens if a patient is incompetent?
If a patient is incompetent, whether it is necessary to save a patient’s life/prevent deterioration in his health, and it accords with his best interests. Whether, in the case of an incompetent patient, the patient is likely to recover so as to be capable of making his own treatment decisions in the near future.
What is covert medication?
Covert medication is the practice of hiding medication in food or beverages so that it goes undetected by the person receiving the medication. Pills may be crushed or medication in liquid form may be used (Griffith 2003). This practice exclusively applies to individuals who are not capable of consenting to treatment.
How high is non-adherence in psychiatric patients?
Estimated rates of non- adherence among all psychiatric patient groups range between 20 and 50%, and rises as high as 70 to 80% among patients with schizophrenia (Breen & Thornhill, 1998). To improve the care of patients with severe mental illness, clinicians and family members sometimes resort to concealing medications in food or drink--a practice referred to as Covert Medication.
Why is empathy important in ethics?
This is because traps can incite tunnel vision; the pull to act on them is so strong that people can become blinded to other behavioral options.
What is a fish trap?
A fish trap is comprised of a wire cage with an entrance shaped like a large funnel that narrows toward the inside of the cage; the design of the funnel directs the fish to swim into the trap. In the same way, an individual or organization is encouraged to move in a certain (unethical) direction once a psychological trap is present.
Who is Paul Hersey?
Paul Hersey, MBA, EdD, is Distinguished Professor of Leadership Studies at Nova Southeastern University. He is best known for developing the concept of “situational leadership” with Ken Blanchard, with whom he co-authored Management of Organizational Behavior, now in its ninth edition.
Why do traps exist?
Traps exist because at any given moment in time people experience impulses that motivate them to act. These impulses are reactions to internal or external stimuli. Sometimes, a stimulus is so powerful or triggers such automatic behavior that the individual acts without recognizing that other options exist.
What is defensive trap?
Although some of them can, at times, be counted as primary traps, defensive traps are basically attempts to find easy ways to reverse course after a transgression has been committed. For the most part, defensive traps are maneuvers that are reactions to two internal stimuli: guilt and shame.
Why are psychological traps insidious?
Psychological traps are insidious because they are often invisible. Managers with a high need for closure, for instance, are usually neither aware of having such a trait nor that it might lead them to disregard the unethical behavior of their coworkers.
What can an executive do to keep the trap of obedience to authority at bay?
When trying to keep the trap of obedience to authority at bay, the most important thing an executive can do is to hire a psychologist to be part of his or her ethics and compliance team. Psychology can explain the nature of traps and often help structure the proper approach to avoiding or remediating them.
