The decision making process including assessment of ethical principles in the commitment of police-referred, psychiatric patients.
OBJECTIVE
to identify determinants for psychiatric commitment and analyse physicians' assessment of ethical principles concerning interested groups on the decision to commit a psychiatric patient.


METHODS
a prospective physician survey concerning commitment of patients brought by police to a psychiatric emergency unit.


METHODS
Two hundred consecutive, police-conveyed patients.


METHODS
psychiatric commitment.


METHODS
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.
Alexius
Birgitta
B
Karolinska Institute, Institution for Clinical Neurosciences, Section of Psychiatry, St. Göran's Hospital, Stockholm, Sweden.
Ajnefors
Lisa
L
Berg
Kerstin
K
Aberg-Wistedt
Anna
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003134:Commitment of Persons with Psychiatric Disorders; D003657:Decision Making; D004637:Emergency Services, Psychiatric; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016495:Police; D011446:Prospective Studies; D013548:Sweden