Am J Psychiatry 1984; 141:202-205
Copyright © 1984 by American Psychiatric Association
Involuntary treatment in medicine and psychiatry
PS Appelbaum and LH Roth
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.
