Involuntary treatment in the context of "Psychiatric medication"

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⭐ Core Definition: Involuntary treatment

Involuntary treatment or mandatory treatment refers to medical treatment undertaken without the consent of the person being treated. Involuntary treatment is permitted by law in some countries when overseen by the judiciary through court orders; other countries defer directly to the medical opinions of doctors.

Globally and even within countries, what is meant by the term "involuntary treatment" is not agreed upon. In/voluntary when applied to medical treatments could refer to a purely legal perspective, an entirely ethical lens, or with components of both. Therefore use of the term is best accompanied by specification to avoid confusion.

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πŸ‘‰ Involuntary treatment in the context of Psychiatric medication

A psychiatric or psychotropic medication is a psychoactive drug taken to exert an effect on the chemical makeup of the brain and nervous system. Thus, these medications are used to treat mental illnesses. These medications are typically made of synthetic chemical compounds and are usually prescribed in psychiatric settings, potentially involuntarily during commitment. Since the mid-20th century, such medications have been leading treatments for a broad range of mental disorders and have decreased the need for long-term hospitalization, thereby lowering the cost of mental health care. The recidivism or rehospitalization of the mentally ill is at a high rate in many countries, and the reasons for the relapses are under research.

A 2022 umbrella review of over 100 meta-analyses found that both psychotherapies and pharmacotherapies for adult mental disorders generally yield small effect sizes, suggesting current treatment research may have reached a ceiling and needs a paradigm shift.

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Involuntary treatment in the context of Medical ethics

Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal. These four values are not ranked in order of importance or relevance and they all encompass values pertaining to medical ethics. However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation. Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.

There are several codes of conduct. The Hippocratic Oath discusses basic principles for medical professionals. This document dates back to the fifth century BCE. Both The Declaration of Helsinki (1964) and The Nuremberg Code (1947) are two well-known and well respected documents contributing to medical ethics. Other important markings in the history of medical ethics include Roe v. Wade in 1973 and the development of hemodialysis in the 1960s. With hemodialysis now available, but a limited number of dialysis machines to treat patients, an ethical question arose on which patients to treat and which ones not to treat, and which factors to use in making such a decision. More recently, new techniques for gene editing aiming at treating, preventing, and curing diseases utilizing gene editing, are raising important moral questions about their applications in medicine and treatments as well as societal impacts on future generations.

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Involuntary treatment in the context of Involuntary commitment

Involuntary commitment, civil commitment, or involuntary hospitalization/hospitalisation, or informally in Britain sectioning, being sectioned, commitment, or being committed, is a legal process through which an individual who is deemed by a qualified person to have symptoms of severe mental disorder is detained in a psychiatric hospital (inpatient) where they can be treated involuntarily. This treatment may involve the administration of psychoactive drugs, including involuntary administration. In many jurisdictions, people diagnosed with mental health disorders can also be forced to undergo treatment while in the community; this is sometimes referred to as outpatient commitment and shares legal processes with commitment. Importantly, the term "involuntary commitment" in the United States does not always refer to a legal intervention, but rather refers to an ethical lens from the perspective of individual autonomy. Users of the term are therefore recommended to define precisely what they mean by "involuntary commitment," such as by clarifying the extent they refer to external pressure, civil rights, individual agency, competence and capacity, and ethics.

Criteria for civil commitment are established by laws which vary between nations. Commitment proceedings often follow a period of emergency hospitalization, during which an individual with acute psychiatric symptoms is confined for a relatively short duration (e.g. 72 hours) in a treatment facility for evaluation and stabilization by mental health professionals who may then determine whether further civil commitment is appropriate or necessary. Civil commitment procedures may take place in a court or only involve physicians. If commitment does not involve a court there is normally an appeal process that does involve the judiciary in some capacity, though potentially through a specialist court.

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Involuntary treatment in the context of Detention (confinement)

Detention is the process whereby a state or private citizen holds a person by removing or restricting their freedom or liberty at that time.

Detention can be due to (pending) criminal charges against the individual pursuant to a prosecution or to protect a person or property. Being detained does not always result in being taken to a particular area (generally called a detention center), either for interrogation or as punishment for a crime (see prison). Persons can be detained if they are not allowed to leave a specific jurisdiction (a type of travel ban known as an 'exit ban') or if they are prevented from traveling to or from a specific area or region. An individual may be detained due a psychiatric disorder, potentially to treat this disorder involuntarily. They may also be detained for to prevent the spread of infectious diseases such as tuberculosis.

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Involuntary treatment in the context of Compulsory sterilization

Compulsory sterilization, also known as forced or coerced sterilization, refers to any government-mandated program to involuntarily sterilize a specific group of people. Sterilization removes a person's capacity to reproduce, and is usually done by surgical or chemical means.

Purported justifications for compulsory sterilization have included population control, eugenics, limiting the spread of HIV, and ethnic genocide.

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Involuntary treatment in the context of Outpatient commitment

Outpatient commitmentβ€”also called assisted outpatient treatment (AOT) or community treatment orders (CTO)β€”refers to a civil court procedure wherein a legal process orders an individual diagnosed with a severe mental disorder to adhere to an outpatient treatment plan designed to prevent further deterioration or recurrence that is harmful to themselves or others.

This form of involuntary treatment is distinct from involuntary commitment in that the individual subject to the order continues to live in their home community rather than being detained in hospital or incarcerated. The individual may be subject to rapid recall to hospital, including medication over objections, if the conditions of the order are broken, and the person's mental health deteriorates. This generally means taking psychiatric medication as directed and may also include attending appointments with a mental health professional, and sometimes even not to take non-prescribed illicit drugs and not associate with certain people or in certain places deemed to have been linked to a deterioration in mental health in that individual.

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