Human Rights in Psychiatry Prospects and Dilemmas of Abolishing Coercion in Mental Health Care

The book describes the ethical lines of conflict, shows why coercion can no longer be justified and analyzes the consequences and dilemmas of a possible abolition of coercive measures in psychiatric care. The use of coercion in mental health care is one of the most controversial topics in psychiatric nursing and psychiatry.

The conflict line centers around the UN-Convention in the Rights of People with Disabilities (CRPD). Advocates of the CRPD are pushing for the complete abolition of coercion while opponents see central medical and legal aspects of care for people with mental health problems at risk.

Clinicians in conventional psychiatry, including many mental health nurses, primarily justify these measures because of the assumed benefits of coercion-associated care and with the argument that many people affected are unable to make appropriate decisions for their own health in a crisis situation. This argument also applies to human rights, for example by basing coercive measures in the event of suicidality on the right to life.

Three central topics are developed in the book. First, it is shown that psychiatric coercion can no longer be justified because the current practice of psychiatric care does not meet the ethico-legal requirements for the use of coercion. Second, a human rights-based approach of psychiatric care is outlined, which is fundamentally based on the will and preferences of people with mental health problems. Third, the consequences and dilemmas are indicated, e.g., the issue of how to deal with suicidality or dementia without the use of coercion.

This book is aimed to receive a specific attention from the psychiatric nursing community.