The decision making process including assessment of ethical principles in the commitment of police-referred, psychiatric patients.

Full Abstract

OBJECTIVES:
to identify determinants for psychiatric commitment and analyse physicians' assessment of ethical principles concerning interested groups on the decision to commit a psychiatric patient.

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

PATIENTS:
Two hundred consecutive, police-conveyed patients.

OUTCOME MEASURE:
psychiatric commitment.

PREDICTOR VARIABLES:
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.

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Author information

Author/s: Alexius, Birgitta (B); Ajnefors, Lisa (L); Berg, Kerstin (K); Aberg-Wistedt, Anna (A);

Affiliation: Karolinska Institute, Institution for Clinical Neurosciences, Section of Psychiatry, St. Göran's Hospital, Stockholm, Sweden.

Journal and publication information

Publication Type: Journal Article

Journal: Medicine and law (Med Law), published in South Africa. (Language: eng)

Reference: 2002-; vol 21 (issue 1) : pp 107-19

Dates: Created 2002/05/17; Completed 2002/06/20; Revised 2004/11/17;

PMID: 12017436, status: MEDLINE (last retrieval date: 11/6/2008)

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