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Autonomy and the psychiatric patient.

E Matthews1

  • 1Dept. of Philosophy, University of Aberdeen, Old Brewery, Old Aberdeen AB24 3UB UK.

Journal of Applied Philosophy
|January 5, 2002
PubMed
Summary

This paper examines justifications for denying treatment refusal rights to psychiatric patients. It argues against denial based on irrationality but suggests it may be permissible for disorders involving a disturbance of personal identity.

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Area of Science:

  • Bioethics
  • Psychiatry
  • Philosophy of Medicine

Background:

  • The right to refuse treatment is a cornerstone of patient autonomy.
  • Existing justifications for overriding this right in psychiatric patients are often debated.
  • Philosophical underpinnings of autonomy, particularly Millian principles, are relevant.

Purpose of the Study:

  • To explore ethical justifications for denying the right to refuse treatment to certain psychiatric patients.
  • To critically evaluate the concept of 'irrationality' as a basis for denying treatment refusal.
  • To identify specific mental disorders where denial of this right might be ethically permissible.

Main Methods:

  • Philosophical analysis of autonomy and rights.
  • Examination of Kantian and Millian ethical frameworks.
  • Conceptual analysis of 'irrationality' and 'personal identity' in psychiatric contexts.

Main Results:

  • Kantian arguments for autonomy are deemed insufficient for justifying treatment refusal denial.
  • Millian arguments, emphasizing the right to self-determination without harm to others, provide a stronger basis.
  • 'Irrationality' is an imprecise term and not a sufficient ground to deny treatment refusal rights.
  • Disturbances in personal identity associated with certain mental disorders may present a case for denying treatment refusal.

Conclusions:

  • Denying treatment refusal rights to psychiatric patients requires careful ethical consideration.
  • The concept of 'irrationality' is not a valid sole justification for overriding patient autonomy.
  • Mental disorders characterized by a profound disturbance of personal identity warrant further ethical debate regarding treatment refusal.
Keywords:
Mental Health TherapiesPhilosophical ApproachProfessional Patient Relationship

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