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At least 163 records · Page 9Linked to original sources
PubMed1992

Clinical encounters with outpatient coercion at the CMHC: questions of implementation and efficacy.

Clinical encounters with three outpatients at a CMHC who were managed with alternating periods of voluntary or uncoerced and involuntary or coerced treatment are presented. The two periods of coerced community treatment--of eight months and then two to four years duration--produced positive results quite distinct from the periods of uncoerced community treatment. In discussing the implementation and efficacy of coerced outpatient treatment at the CMHC, the author addresses legal, clinical, and resource issues which form the basis for seven arguments often heard as to why staffs at CMHCs hesitate to employ involuntary or coercive interventions.

Adult↗
PubMed1995

From conversion to coercion: the police role in medication compliance.

This paper examines the role of the police in supporting community based mental health services for the chronically mentally ill in a mid-sized midwestern city. Cooperation between the police and mental health system, as reflected in training and procedural agreements for emergency evaluations and hospitalization, achieves the conversion of the police to a medical model view of mental illness which stresses the importance and effectiveness of medication compliance so that the police will act upon this belief in their handling of the mentally ill. However, police recognition of the limits of the medical model and organizational change impacts upon cooperative police practices. Police experience conflict over the assumed therapeutic goals of community treatment and the important gatekeeping function community mental health systems perform under deinstitutionalization. Erosion of the police belief in the effectiveness of community mental health, and the resulting change in practices, may provide an important, yet partial, counterbalance to the control exerted by the medical model. The availability of police authority to assure compliance, or in some cases to reinforce the consequences of non-compliance with medication, raises questions about police-mental health relationships that are too cooperative.

Antipsychotic Agents↗
PubMed1996

Compliance, coercion, and compassion: moral dimensions of the return of tuberculosis.

Since 1986, we have seen a rise in the occurrence of tuberculosis in the United States. Long considered defeated in this country, the disease is returning with distressing vigor. Outbreaks of MDR-TB, tuberculosis resistant to more than one medication, have been reported around the country. This article analyzes the Centers for Disease Control and Prevention's National Action Plan to Combat Multidrug-Resistant Tuberculosis, with particular focus on the moral dimensions of mandatory directly observed treatment (DOT) and involuntary quarantine. It is proposed that a moral response to the control of tuberculosis must be one which is sustainable and which can effectively curtail the spread of the disease at a minimal cost to individual rights.

Altruism↗
PubMed2006

[Ideals of beauty and the medical manipulation of the body between free choice and coercion].

DEFINITION OF THE PROBLEM: There is an increasing demand for invasive forms of cosmetic surgery. In view of the omnipresent confrontation with some idealized standards of beauty in advertising, films, beauty-shows etc., this paper deals with the question of whether women undergo cosmetic surgery because they are forced by a norm-setting beauty system or whether they choose these operations themselves. ARGUMENTS: I offer an analysis of what could be an adequate concept of autonomous choice in this area. Particularly, it will be shown that a libertarian concept of autonomy is inadequate for analyzing the moral status of cosmetic surgery. CONCLUSION: A concept of autonomy is outlined that enables us to qualify certain kinds of pressure as autonomy restricting.

Beauty↗
PubMed2005

Experiences of coercion during investigation and treatment.

According to Swedish legislation (LVM) compulsory treatment shall be decided on if someone, due to ongoing abuse of alcohol, drugs or volatile solvents, is in need of care to overcome abuse and if a voluntary intervention is not possible. Very little research has been conducted in Sweden on this particular legislation with regard to the clients' experiences of entire process from assessment to aftercare. We interviewed 74 subjects who were being assessed prior to the court's decision on involuntary care (n=39), or with previous experience of assessment and involuntary care (n=35). The assessment group more often reported having the opportunity to express their opinions to the social worker during the assessment period (55% vs. 21%, p<.05) and they were more positive towards the final decision (60% vs. 24%, p<.05). In spite of the law, 18% were not contacted by the social services while in coercive treatment. The clients who did meet with a social worker, often described the conferences as more of a perfunctory nature with a lack of focus on the actual situation and aftercare planning. This study points at a need of studying the subjects' experiences of the whole continuum of the coercive process: from the investigation, to treatment and to aftercare. It also points at the need for new instruments to be developed covering all aspects of the coercive process and in particular the period of investigation prior to the decision on involuntary care.

Adult↗
PubMed2006

Involuntary outpatient treatment as "desintitutionalized coercion": the net-widening concerns.

In American jurisprudence, two justifications have traditionally been put forth to support the government's social control of persons with mental illness: police power and parens patriae. As public mental hospitals became less available as loci in which to exercise these functions, governments sought alternative means to achieve the same ends. One prominent but quite controversial means is involuntary outpatient treatment (IOT). While the concerns about IOT have been myriad, one often alluded to but never documented is that of "net-widening." That is, once IOT became available, it would be applied to an ever greater number of individuals, progressively expanding the margins of the designated population to whom it is applied, despite the formal standard for its application remaining constant. We tested the net-widening belief in a naturalistic experiment in Massachusetts. We found that net-widening did not occur, despite an environment strongly conducive to that expansion. At this time, whatever the arguments against IOT might be, net-widening should not be one of them.

Ambulatory Care↗