Commentary

Ethics in compulsory treatment of patients with severe mental illness


 

Take-home points

  • Certain patients with psychosis have fairly high functioning.
  • Milieu therapy is, in certain cases, able to assuage some symptoms of psychosis.
  • Compulsory antipsychotic administration may not be ethical in certain cases of acute psychosis.
  • Biological reductionism may undermine a complete ethical understanding of psychosis.
  • Psychiatric disorders are etiologically complex and multifactorial.
  • Involuntary treatment may provide short-term gains, but prevent long-term trust between patient and provider.

Dr. Badre is a forensic psychiatrist in San Diego and an expert in correctional mental health. He holds teaching positions at the University of California, San Diego, and the University of San Diego. He teaches medical education, psychopharmacology, ethics in psychiatry, and correctional care. Dr. Badre also mentors several residents on projects, including reduction in the use of solitary confinement of patients with mental illness, reduction in the use of involuntary treatment of the mentally ill, and examination of the mentally ill offender.

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