[Forced medical treatment: existent law and its limitations in a general hospital]

The conditions in which we can provide medical treatment without informed consent are detailed in the Israeli Law for Treating the Mentally Ill [1991), and the Law of Patient Rights (1996). Our clinicaL experience in a general hospital indicates that the law does not provide a satisfactory solution in cases where the patient is actively resisting emergency treatment. This may be the case for patients suffering from dementia, personality disorders or substance abuse disorders. Not infrequently, the physician finds himself perplexed in face of a genuine ethical/juridical dilemma, without being able to use the law efficiently or, at times, even implement it pragmatically. in this article, we review the array of laws by which Israeli physicians in general, and psychiatrists in particular, operate upon when deciding to treat a patient against his will in a general hospital. We describe and discuss a clinicaL case that raises fundamental questions concerning the existing law. We also discuss other complex cases, such as anorexia, debating the possibility of coercing medical treatment on someone who is not mentally ill--psychotic according to Israeli juridical system. Finally, we raise a few ideas as to how the present condition can be improved.