Civil Commitment

2019 ◽  
pp. 65-70
Author(s):  
Elizabeth Ford
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Civil Commitment ◽  
Critical Factor ◽  
Individual Autonomy ◽  
Police Power ◽  
Involuntary Hospitalization ◽  
Legal Cases

Chapter 6 covers the major legal cases that have informed the laws governing the civil commitment – involuntary hospitalization – of individuals with mental illness. The cases highlight the evolution of the emphasis on dangerousness as a critical factor in decision-making and very clearly describe the tension between individual autonomy and police power. The cases included in this chapter are Lake v. Cameron, Baxstrom v. Herold, Lessard v. Schmidt, O’Connor v. Donaldson, Addington v. Texas, and a case involving children, Parham v. J.R.

Civil Commitment

2014 ◽  
pp. 43-47
Author(s):  
Elizabeth Ford
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Civil Commitment ◽  
Critical Factor ◽  
Individual Autonomy ◽  
Police Power ◽  
Involuntary Hospitalization ◽  
Legal Cases

Chapter 6 covers the major legal cases that have informed the laws governing the civil commitment—involuntary hospitalization—of individuals with mental illness. The cases highlight the evolution of the emphasis on dangerousness as a critical factor in decision-making and very clearly describe the tension between individual autonomy and police power. The cases included in this chapter are Lake v. Cameron, Baxstrom v. Herold, Lessard v. Schmidt, O’Connor v. Donaldson, Addington v. Texas, and a case involving children, Parham v. J.R.

Involuntary hospitalization

2021 ◽  
pp. 279-298
Author(s):  
Christopher James Ryan ◽  
Jane Bartels
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Clinical Features ◽  
Real World ◽  
Inpatient Treatment ◽  
Psychiatric Treatment ◽  
Ethical Question ◽  
Involuntary Treatment ◽  
Involuntary Hospitalization ◽  
Decision Making Capacity

The chapter outlines a series of arguments designed to answer possibly the most important ethical question in psychiatry: under what circumstances, if any, is it ethically justifiable to treat people with clinical features of mental illness, despite their objection? We argue that involuntary inpatient treatment is ethically justified, but only in circumstances where: the objection to treatment was made without decision-making capacity; there is no reason to believe that the person would have objected had he or she been competent; the treatment will protect the person from serious harms (when balancing these with any harms associated with the treatment); and involuntary treatment represents the avenue for protection least restrictive of the person’s freedom. Having established a model for ethically justified involuntary inpatient psychiatric treatment, we examine how it can be applied to two real-world cases.

What Patients With Severe Mental Illness Transitioning From Hospital to Community Have to Say About Care and Shared Decision-Making

2016 ◽  
Vol 37 (6) ◽  
pp. 400-405 ◽  
Author(s):  
Dawn I. Velligan ◽  
David L. Roberts ◽  
Cynthia Sierra ◽  
Megan M. Fredrick ◽  
Mary Jo Roach
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Shared Decision Making ◽  
Shared Decision

The capacity to designate a surrogate is distinct from decisional capacity: normative and empirical considerations

2021 ◽  
pp. medethics-2020-107078
Author(s):  
Mark Navin ◽  
Jason Adam Wasserman ◽  
Devan Stahl ◽  
Tom Tomlinson
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Decisional Capacity ◽  
Risks And Benefits ◽  
Relative Risks ◽  
Decision Making Capacity ◽  
Cognitive Diseases ◽  
Surrogate Selection

The capacity to designate a surrogate (CDS) is not simply another kind of medical decision-making capacity (DMC). A patient with DMC can express a preference, understand information relevant to that choice, appreciate the significance of that information for their clinical condition, and reason about their choice in light of their goals and values. In contrast, a patient can possess the CDS even if they cannot appreciate their condition or reason about the relative risks and benefits of their options. Patients who lack DMC for many or most kinds of medical choices may nonetheless possess the CDS, particularly since the complex means-ends reasoning required by DMC is one of the first capacities to be lost in progressive cognitive diseases (eg, Alzheimer’s disease). That is, patients with significant cognitive decline or mental illness may still understand what a surrogate does, express a preference about a potential surrogate, and be able to provide some kind of justification for that selection. Moreover, there are many legitimate and relevant rationales for surrogate selection that are inconsistent with the reasoning criterion of DMC. Unfortunately, many patients are prevented from designating a surrogate if they are judged to lack DMC. When such patients possess the CDS, this practice is ethically wrong, legally dubious and imposes avoidable burdens on healthcare institutions.

scholarly journals Skills-based intervention to enhance collaborative decision-making: systematic adaptation and open trial protocol for veterans with psychosis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Emily B. H. Treichler ◽  
Borsika A. Rabin ◽  
William D. Spaulding ◽  
Michael L. Thomas ◽  
Michelle P. Salyers ◽  
...  
Keyword(s):  
Decision Making ◽  
Mental Illness ◽  
Service Delivery ◽  
Serious Mental Illness ◽  
Qualitative Interviews ◽  
Skills Training ◽  
Mental Illnesses ◽  
Open Trial ◽  
Collaborative Decision Making ◽  
Collaborative Decision

Abstract Background Collaborative decision-making is an innovative decision-making approach that assigns equal power and responsibility to patients and providers. Most veterans with serious mental illnesses like schizophrenia want a greater role in treatment decisions, but there are no interventions targeted for this population. A skills-based intervention is promising because it is well-aligned with the recovery model, uses similar mechanisms as other evidence-based interventions in this population, and generalizes across decisional contexts while empowering veterans to decide when to initiate collaborative decision-making. Collaborative Decision Skills Training (CDST) was developed in a civilian serious mental illness sample and may fill this gap but needs to undergo a systematic adaptation process to ensure fit for veterans. Methods In aim 1, the IM Adapt systematic process will be used to adapt CDST for veterans with serious mental illness. Veterans and Veteran’s Affairs (VA) staff will join an Adaptation Resource Team and complete qualitative interviews to identify how elements of CDST or service delivery may need to be adapted to optimize its effectiveness or viability for veterans and the VA context. During aim 2, an open trial will be conducted with veterans in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) to assess additional adaptations, feasibility, and initial evidence of effectiveness. Discussion This study will be the first to evaluate a collaborative decision-making intervention among veterans with serious mental illness. It will also contribute to the field’s understanding of perceptions of collaborative decision-making among veterans with serious mental illness and VA clinicians, and result in a service delivery manual that may be used to understand adaptation needs generally in VA PRRCs. Trial registration ClinicalTrials.gov Identifier: NCT04324944

Rethinking individual autonomy in medical decision-making for young adults reliant on caregiver support: A case report and analysis

2021 ◽  
pp. 147775092110698
Author(s):  
Alexia Zagouras ◽  
Elise Ellick ◽  
Mark Aulisio
Keyword(s):  
Decision Making ◽  
Young Adults ◽  
Medical Decision Making ◽  
Life Experience ◽  
Pregnant Patient ◽  
Medical Decision ◽  
Individual Autonomy ◽  
Caregiver Support ◽  
Neurological Condition ◽  
Decision Making Capacity

There is a gap in the clinical bioethics literature concerning the approach to assessment of medical decision-making capacity of adolescents or young adults who demonstrate diminished maturity due to longstanding reliance on caregiver support, despite having reached the age of majority. This paper attempts to address this question via the examination of a particular case involving assessment of the decision-making capacity of a young adult pregnant patient who also had a physically disabling neurological condition. Drawing on concepts from adolescent bioethics and feminist critiques of bioethical theory, we argue that limited life experience, secondary to a disabling neurological condition, can result in a lack of adult-like capacity even in a patient who is legally an adult. In such cases, it may be that autonomy, to the extent that it is to be relevant and meaningful, must be viewed through a relational lens. Furthermore, clinicians may avoid unjustifiably paternalistic practices by working with the patient help her gain a better appreciation of the consequences of her decision, thereby calling forward her capacity rather than resorting to being directive in counseling. We conclude that lessons from this case can be used to approach ethically complex instances of medical decision-making in adult patients with normal cognition but diminished experiential maturity.

基於儒家家庭本位思想的知情同意原則的思考

2013 ◽  
Vol 11 (1) ◽  
pp. 33-44
Author(s):  
Xiangjin KONG ◽  
Mingjie ZHAO
Keyword(s):  
Decision Making ◽  
Filial Piety ◽  
Moral Virtue ◽  
Family Members ◽  
Confucian Ethics ◽  
Medical Decision ◽  
Individual Autonomy ◽  
The Family ◽  
Family Decision ◽  
Opinion Polls

LANGUAGE NOTE | Document text in Chinese; abstract also in English.在具有家庭主義特徵的中國社會文化語境下，儒家家庭本位思想對病人知情同意權的影響是客觀實在。以自由主義和個人主義為理論基礎的個人自主知情同意原則要想在中國本土的醫療實踐中發揮應有作用，突顯家庭在知情同意過程中的主導地位是重要前提。在中國的醫療實踐中，知情同意的模式必須融入中國儒家家庭本位思想，才能更好地發揮其作用。Opinion polls released recently show that the majority of people in China today think that informed consent in medical practice is necessary, with more than half favoring family decision making over individual, autonomous patient decision making. Based on these opinion polls, this essay argues that the liberalism and liberal individualism that emphasize individual autonomy do not square with the Confucian tradition.The essay submits that the “family decision” model is designed to embody Confucian family ethics and maximize the benefit of family involvement in medical decision making. The family model includes both the patient and his or her close family members in the decision making process. The Confucian ethics of humanness (ren) – the highest moral virtue – and filial piety (xiao) – the foundation of all moral virtue – support family as the most appropriate authority for medical decisions. Further, the essay explores how the family as a unit is better positioned to work with the physician at critical moments to protect the interests of the patient. This means that the family, not the patient, is in authority, and that in some cases, it is acceptable for family members to hide “medical information” from the patient with the cooperation of the physician. The essay concludes that the family is, and should be treated as, a significant moral participant in medical decision making.DOWNLOAD HISTORY | This article has been downloaded 99 times in Digital Commons before migrating into this platform.

scholarly journals Storytelling, Safeguarding, Treatment, and Responsibility: attributes of recovery in psychiatric intensive care units

2014 ◽  
Vol 11 (02) ◽  
pp. 105-118 ◽  
Author(s):  
Karleen Gwinner ◽  
Louise Ward
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Illness ◽  
Intensive Care ◽  
Lived Experience ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Review Of Literature ◽  
Psychiatric Distress ◽  
Nurse Knowledge

AbstractBackground and aimIn recent years, policy in Australia has endorsed recovery-oriented mental health services underpinned by the needs, rights and values of people with lived experience of mental illness. This paper critically reviews the idea of recovery as understood by nurses at the frontline of services for people experiencing acute psychiatric distress.MethodData gathered from focus groups held with nurses from two hospitals were used to ascertain their use of terminology, understanding of attributes and current practices that support recovery for people experiencing acute psychiatric distress. A review of literature further examined current nurse-based evidence and nurse knowledge of recovery approaches specific to psychiatric intensive care settings.ResultsFour defining attributes of recovery based on nurses’ perspectives are shared to identify and describe strategies that may help underpin recovery specific to psychiatric intensive care settings.ConclusionThe four attributes described in this paper provide a pragmatic framework with which nurses can reinforce their clinical decision-making and negotiate the dynamic and often incongruous challenges they experience to embed recovery-oriented culture in acute psychiatric settings.

Sign in / Sign up

Export Citation Format

Share Document