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Updated: Jul 11, 2026
Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 17, 2011
The decision making process including assessment of ethical principles in the commitment of police-referred,
Birgitta Alexius1, Lisa Ajnefors, Kerstin Berg
1Karolinska Institute, Institution for Clinical Neurosciences, Section of Psychiatry, St. Göran's Hospital, Stockholm, Sweden.
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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