Involuntary treatment in medicine and psychiatry

It is often asserted in the debate on the right to refuse treatment that psychiatrists are the only physicians who treat patients against their will. During 11 weeks on two wards in a general medical hospital, the authors observed 18 episodes of involuntary treatment and restraint (1.17 episodes per 100 patient-days). Involuntary treatment was usually employed when the refusals of patients judged incompetent interfered with needed treatment. Restraints and psychoactive medications were the most common interventions. These data suggest that involuntary psychiatric treatment is mirrored in general medicine and has its roots in medical paternalism, rather than in the function of social control.