Philosophy 311: Morals & Medicine
Theodore Gracyk


Normally, FOUR STEPS are involved for involuntary treatment or confinement.

  • Determination of mental disorder. A typical law defines a mental disorder as, "Any organic, mental, or emotional impairment which has substantial adverse effects on an individual's cognitive (thought) or volitional (action) functions." Involuntary confinement and treatment for purposes of mental evaluation are limited to 72 hours. This initial step requires confinement that is ordered and supervised by a licensed mental health professional.

  • Within 72 hours of initial confinement, a court must find that it is necessary to protect the person or the public, or to facilitate effective treatment for treating the person. This court finding can permit involuntary confinement or treatment for a limited time (usually 2 weeks or 30 days), after which another court finding can extend it. Indefinite time periods are NOT permitted.

  • The physician must choose among the least restrictive treatment alternatives necessary to protect the individual and the public and permit effective treatment.

  • There must be public notice of the reasons why confinement or involuntary treatment was chosen from among the other alternatives.

There are specific criteria for commitment for mental evaluation.

  • HARM TO SELF: A substantial risk of serious harm indicated by threats (written or verbal) or attempts to commit suicide or inflict physical harm on one's self.
  • HARM TO OTHERS: Behavior that has caused harm or places others in reasonable fear of sustaining harm. Can be written, verbal, or actual assaultive acts.
  • PROPERTY DAMAGE: Behavior that has already taken place that has caused substantial loss or damage to the property of others.
  • GRAVELY DISABLED: Behavior that results in the individual being in danger of serious physical harm resulting from the failure to provide for his/her needs of health and safety or, the individual has shown a deterioration in routine functioning which is evidenced by a repeated and escalating loss over his/her actions and is not receiving necessary care for health and safety needs.

ETHICAL PROBLEM: Three of the four criteria are PREVENTIVE.

However, preventive confinement is immoral when directed at mentally competent people.

Furthermore, competent people have the right to refuse treatment even if it is in their best interests to have it.

TONY HOPE: To allow preventive confinement & involuntary treatment is UNJUST, because it treats persons with mental disorders differently.


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            Last updated Oct. 15, 2008