PsychOdyssey has added a new article to the syllabus of PsychOdyssey 350: Compulsory Treatment. It is:
Olsen, D. P. (2003), Influence and Coercion: Relational and Rights-Based Ethical Approaches Ethical Approaches to Forced Psychiatric Treatment. Journal of Pyschiatric and Mental Health Nursing, 10, 705-712.
Olsen expands the traditional philosophical foundation for involuntary commitments and mandatory treatment from a rights-based approach to a relational approach. Olsen’s focus on a relational approach should be of interest to all families struggling with the thorny issue of mandatory treatment for their loved ones.
From the abstract: The dominant rights-based approach to the ethics of coercion in psychiatric treatment guides clinicians in deciding whether treatment should be compelled or the patient’s autonomy respected, but provides no guidance across the remaining broad continuum of inﬂuence that clinicians exert with patients. The assumptions of the rights-based approach lead to three dichotomous decisions: (1) ‘Is the treatment voluntary?’; (2) ‘Is the patient competent?’ and (3) ‘Are the consequence of no treatment dangerous?’. The assumptions of a relational approach lead to ethical guidance across the full range in the intensity and types of inﬂuence which may be ethically justiﬁed or required in psychiatric treatment. These assumptions are: (1) inﬂuence is inherent in the clinical relationship; (2) the relevant factors are continuous and (3) all decisions are subjective. While the rights approach emphasizes deﬁning competence and developing techniques to predict future patient dangerousness, the relational approach emphasizes patient–clinician responsibilities in ethical relationships and understanding all factors which legitimately bear on the use of inﬂuence.