An outpatient treatment approach directed to patients with histories of
psychotically based dangerousness, poor compliance, and recidivism is
described. Cases are presented that suggest favorable outcomes of this
approach, but the coercive nature of the treatment raises questions about
the psychiatrist's violation of patients' rights and transgression of
ethical standards. If psychiatrists are to successfully treat the most
difficult chronic patients, can we do it without legally sanctioned,
benevolent, coercive treatments? One model of such treatment is outpatient
commitment. There is concern that without sound outpatient commitment
statutes, we may witness the reemergence of asylums.Abstract Teaser