title: Advance directives in a correctional setting.
abstract: Using advance directives to preconsent to mental health treatment is a promising approach to contending with the quandary posed by patients suffering from severe mental health illness, particularly those in a prison setting. The implementation of advance directives represents unfamiliar territory because it focuses on the patient's ability to preconsent to treatment rather than the commonly interpreted prerefusal of treatment. The challenge of consenting in the prison system generates a set of unique problems. The environment in which the instrument is signed can impose significant pressures and therefore result in a viable legal challenge. The prison setting is the most coercive environment in which a patient can be treated, particularly when the patient is mentally ill. Mentally ill prisoners signing preconsent for treatment advance directives have an opportunity for unprecedented relief yet may also experience pressure to select treatments desirable to the prison staff.
authors.affiliation: Florida Department of Corrections, 2601 Blairstone Road,Tallahassee, Florida 32399, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Thomas
authors.forename: J M
authors.initials: JM
authors.lastname: Watson
mesh_terms: D016223:Advance Directives / Q000331:legislation & jurisprudence*; D002961:Civil Rights; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D035082:Federal Government; D005431:Florida; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence*; D016743:Mental Competency; D008605:Mental Health Services / Q000331:legislation & jurisprudence; D028642:Persons with Psychiatric Disorders; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D028701:Patient Rights / Q000331:legislation & jurisprudence; D011329:Prisoners; D011330:Prisons; D011619:Psychotropic Drugs; D013219:State Government; D035521:Supreme Court Decisions; D016312:Treatment Refusal / Q000331:legislation & jurisprudence*; D014481:United States; D028761:Withholding Treatment / Q000331:legislation & jurisprudence
chemical_list: D011619:Psychotropic Drugs