The Decision Making Process Including Assessment of Ethical Principles in the Commitment of Police-Referred, Psychiatric Patients
Aberg- Wistedt, Anna
Medicine and Law: World Association for Medical Law 2002; 21(1): 107-119
OBJECTIVES: to identify determinants for psychiatric commitment and analyse physicians' assessment of ethical principles concerning interested groups on the decision to commit a psychiatric patient. DESIGN: a prospective physician survey concerning commitment of patients brought by police to a psychiatric emergency unit. PATIENTS: Two hundred consecutive, police-conveyed patients. OUTCOME MEASURE: psychiatric commitment. PREDICTOR VARIABLES: psychiatric symptoms, diagnosis, risk for suicide/violence, ethical benefits/costs, physicians' gender, age and education. RESULTS: 56% of the patients were committed. Commitment correlated with a low score on the function assessment scale, patients' negative/ambivalent attitude towards hospitalisation, and diagnosis of psychosis or organic mental disorder. More specialists believed hospitalisation to fulfil patients' autonomy and benefit patients, families, and the community. CONCLUSIONS: dangerousness was often not identified as an indication for commitment. Assessments of commitment's ethical benefits for a patient compared to costs for violation of the patient's autonomy often gave more weight to the former.
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