title: Is supervised community treatment ethically justifiable?
abstract: Ethical viewpoints for and against the use of supervised community treatment (SCT), also known as outpatient commitment and community treatment orders, are examined. The perspectives of writers on civil liberties are considered. This paper argues that while civil liberties are an important concern SCT is ethically justifiable in the circumscribed population of 'revolving door' patients it applies to. This is on the grounds that it enables individuals to actualise their positive liberty. The issue of insight into mental illness is also considered and it is concluded that a further argument in favour of SCT comes from evidence that insight relates to neurobiological deficits. Limits to the ethical justifiability of SCT are considered with reference to individuals with substance dependency. The paper concludes that SCT is ethically permissible only in those with severe mental illness who have a history of losing capacity to consent to treatment and/or admission.
authors.affiliation: Mental Health Department, Bassetlaw Hospital, Kilton Hill, Worksop, Nottinghamshire S81 0BD, UK. eric.dale@nottshc.nhs.uk
authors.forename: Eric
authors.initials: E
authors.lastname: Dale
mesh_terms: D002961:Civil Rights / Q000941:ethics*; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003156:Community Mental Health Services / Q000941:ethics / Q000331:legislation & jurisprudence; D004739:England; D004992:Ethics, Medical; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D037141:Mandatory Programs / Q000941:ethics*; D001523:Mental Disorders / Q000628:therapy*; D014852:Wales