[The practice of compulsory patient commitment]

In Switzerland civil law allows compulsory hospitalization under defined circumstances. It is in the power of municipal authorities to decide on compulsory treatment, though in many of the Swiss cantons this power has been delegated to physicians. This paper first specifies the requirements for medical certificates directing compulsory hospitalization. Then 100 not selected medical certificates from 1997-2000 are compared to these requirements. Only 21% of the certificates met with all the requirements of form and content, nearly half of them showed formal deficiencies. The certificates issued by psychiatrists (n = 44) turned out to be more correct and complete in form and content than the certificates issued by not psychiatric hospital doctors (n = 26) and those issued by general practitioners (n = 30). It seems that not specialized (not psychiatric) doctors, who are rarely confronted with patients requiring compulsory treatment, are overcharged with this delicate and demanding task. To blame is also the passivity of the municipal authorities, who do not exercise their supervision task and seem to be happy having delegated the delicate problem of compulsory hospitalization to physicians.