The ethics of mandatory community treatment.
The authors present three ethical arguments to address the controversy of mandatory community treatment: rights-based versus beneficence, utilitarian, and communitarian. Each approach suggests that mandatory community treatment can be an ethical intervention for individuals with severe mental disorders in well-defined circumstances. It is critical to recognize that such interventions cannot be effective in the absence of an adequately funded, quality mental health service system. Within such a system, the authors believe a program of mandatory community treatment may play an important role. In considering mandatory outpatient treatment, the authors argue that consideration of decisionmaking capacity is preferable to dangerousness criteria, that clinical criteria with some flexibility should be developed so that mandatory community treatment is used only when alternatives have failed, that mandatory community treatment should be implemented long enough to be effective, and that consumers must be involved in the development and implementation of mandatory outpatient treatment programs.
Munetz
Mark R
MR
County of Summit Alcohol, Drug Addiction and Mental Health Services Board, 100 W. Cedar Street, Suite 300, Akron, OH 44307, USA. mmunetz@neoucom.edu
Galon
Patricia A
PA
Frese
Frederick J
FJ
D026686:Beneficence; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003156:Community Mental Health Services / Q000941:ethics* / Q000331:legislation & jurisprudence; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D028701:Patient Rights / Q000941:ethics*; D014481:United States