title: [Involuntary treatment of mental patients in the community: legal and ethical dilemmas].
abstract: This article focuses on the measure of involuntary treatment of mental patients in the community, not only with regard to human rights and more specifically those of persons with mental disorders, but also with regard to ethics and deontology in mental healthcare delivery service. In this light, the important role of informed consent in psychiatry with regard to the psychiatric act is examined. Informed consent of mental patients in treatment when they are in need of voluntary or involuntary hospitalization is further examined, while emphasis is being put on the case of involuntary treatment. The Convention for Human Rights and Biomedicine (Convention of Οviedo), the European Convention of Human Rights, other documents of International Organizations (UN) and specialized national legislation (A. 2071/1992, Chapter vi, Greek law) constitute basic reference and interpretation points. The examination of consent and the demarcation of the exceptions are important issues that need to be approached. More particularly, our interest lies with the article 7 of the Convention for Human Rights and Biomedicine, which specifically refers to the protection of person who suffers from a mental disorder. The opinion that informed consent in psychiatric treatment and involuntary treatment are concepts and processes which are distinct but not always mutually exclusive is enhanced. In any case, involuntary treatment causes major dilemmas as far as informed consent in the psychiatric act is concerned, as it raises issues that affect the autonomy of the person. Today, however, there are many factors which influence public politics towards the adoption of the measure of involuntary treatment within the community. How is it that this paradoxical link is legitimized and justified: involuntary treatment and community? The enactment of the above mentioned measure in many European and North American countries has created new paths in the practice of contemporary psychiatry. Nonetheless, it continues to divide the psychiatric and legal word for it causes intense questioning from a legal, ethical, deontological and clinical aspect, as it offends fundamental rights of the individual. In a legal civilization, in which the principle of informed consent or refusal constitutes a basic rule of the lawfulness of the medical and psychiatric act, any divergence from this rule has consequences for the patients and affects a well-tempered therapeutic treatment. The above mentioned measure could be counterbalanced by the legal regulation of advance directives and the provision for the appointment of a proxy person by the mental patient.
authors: Department of Health and Social Welfare Management, TEI of Athens, Athens, Greece.
authors: M
authors: M
authors: Mitrossili
mesh_terms: D016223:Advance Directives / Q000941:ethics / Q000331:legislation & jurisprudence; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003156:Community Mental Health Services / Q000941:ethics* / Q000331:legislation & jurisprudence*; D028663:Ethical Theory; D004992:Ethics, Medical; D006115:Greece; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence; D010344:Patient Advocacy / Q000941:ethics / Q000331:legislation & jurisprudence; D019727:Proxy / Q000331:legislation & jurisprudence