Clinical and moral uncertainty in psychiatry: the problem of scarce resources

• Published in: Postgraduate medical journal Vol. 85; no. 1008; pp. 507 - 508
• Main Authors: Doyal, Len, Doyal, Lesley, Sokol, Daniel
• Format: Journal Article
• Language: English
• Published: England The Fellowship of Postgraduate Medicine 01.10.2009; Oxford University Press
• Subjects: Clinical medicine; Developed Countries; Developing Countries; Duty of care; ethics; Health Resources - economics; Health Resources - ethics; Humans; Medical diagnosis; Mental Competency; Mental disorders; Mental Disorders - therapy; Mental health care; Poverty; psychiatry; Psychiatry - economics; Psychiatry - education; Psychiatry - ethics; Uncertainty
• ISSN: 0032-5473; 1469-0756
• DOI: 10.1136/pgmj.2009.089862

In practice, this means that detaining and forcing treatment on patients with serious mental disorders can only be deemed appropriate when any immediate harm is outweighed by long term benefit. [...]patients demonstrate that they have the capacity to control rather than to be controlled by their turbulent emotional storms, their vulnerability should take priority over any concern about levels of autonomy already compromised by illness. [...]the physical environment of care should be designed to reinforce those other means of optimising the autonomy of patients.\n Under these circumstances it will not always be clear morally where clinical convenience ends and necessity begins.