Ethical Issues Associated With Forced Medication (Essay Sample)

Ethical Issues associated with forced MedicationNameInstructorCourseInstitutionDate
Ethical Issues associated with forced Medication
Psychiatrists treating mental illnesses are faced by a myriad range of ethical issues to consider in their practice, ranging from telling the truth to acutely ill patients or patients with paranoia about the seriousness of their condition to issues regarding their medication (Latha, 2010). The latter has serious ramifications, especially when patients with mental capacity are put under forced medication. According to Larcher, Craig, Bhogai, Wikinison, and Brierley (2012) a competent adult has a legal right to refuse treatment regardless the fact that his informed decision is likely to adversely affect him. This means that mental health professional are supposed to respect even unwise decisions made by patients with mental capacity to make decisions about their treatment because no one should legally provide consent for medication for such persons. This paper will analyze the ethical dilemma facing mental health patients with respect to their duty to administer medication to patients.
Cohen and Ezer (2013) theorized that consent to medical treatment is arguably the most critical principle that governs the law about treating people with mental health problems or illness. Likewise also, Klein (2012) argued that forced medication violates a person’s competence, insight and competence. The philosophy behind consent to medical treatment is that forced treatment on patients potentially violates the probation against violent and degrading treatment that violates human rights (Latha, 2010). Therefore, patients should be accorded their right to autonomy and self determination through informed consent for their treatment, provided they the mental capacity to decide.
Mental health professionals should carefully consider the degree of moral weight the value of doing good and avoid harm when deciding on respecting the value of patients with impaired decision making capabilities (Latha, 2010), for instance a patient suffering from advanced schizophrenia. Therefore, psychiatrists are expected to wisely consider forced medication or treatment because it might result to irreversible damages such as diminishing the chances of recovery because compliance is highly unlikely, breach of trust between physicians and patients, and increased vulnerability of potential patient abuse (Latha, 2010). Nevertheless, proponents of forced and covert/surreptitious administered medication support are motivated by the claim that it is the duty of a physician to ensure well-being of the patients without the competence to give informed consent.
A Case Scenario
Mary, a fictitious name, came into the clinic and reported that her husband-Peter- had been behaving strangely lately. She claimed that her husband seemed to be in distress and was no longer eating. She also stated that he was easily agitated and was worried that his condition was worsening. She therefore asked whether our mental health professionals could pay him a visit to conduct preliminary analysis, and possibly invite him into the clinic for mental health examination.
The crisis team, where I am a member, paid the Peter a visit to determine the seriousness of his condition and potentially invite him into the clinic for more examination. When we arrived at his home, we found him reading a newspaper and he welcomed us. He was casually dressed in a jean, t-shirt, and pair of sneakers. From his physical appearance he seemed normal. We introduced ourselves and briefed him that his wife was worried about him. He seemed calm until one of the team members told him that he needed help to ensure that his condition did not worsen. He was quick to deny that he did not have any condition, and he certainly did not need any intervention. We treated his claims as routine denials that most of our clients seem to have, hence none of us was alarmed; even by his agitation because we have become accustomed to such reactions from most of our clients. He later calmed down and declared that he was willing to corporate and undergo any necessary medical examinations to proof that he was okay. We booked him an appointment for the following day.
He honored his appointment and his wife accompanied him to the clinic. He was put into the in-patient unit and mental examination commenced. In the cause of the examination, it was discovered that he was not exactly mentally ill but the couple was going through a divorce. He was not only stressed about separating with his wife of 20 years, but he was also involved in legal battle with his wife for the custody of their children. Although these circumstances could have resulted to symptoms that his wife noted, the physician prescribed him Risperidone for psychosis because of his agitation episodes, which he claimed were unpredictable. Although the client insisted that he was not mentally ill and he did not need the medication, the doctor forced him to take the medication.
I did not think prescribing psychotic medication for him was the right decision because he did not exhibit alarming signs of mental illness besides his, otherwise normal, reaction of a normal husband and father in the blink of losing his family. In addition, a history of mental illness could potentially minimize his chances of getting custody of his parents, especially if he identified with history of mental illness.
The Kantianism theoretical framework of forced medication
Immanuel Kant, a German philosopher derived the deontological theory to support his argument about the significance of intension, respecting three distinct imperative, and adhering to personal moral duties (Ohreen & Petry, 2012). Kantianism, named after Immanuel Kant, emphasizes on widespread moral duty, which determines the intention behind an action. Therefore, Kantianism is based on duty, supported by the notion that the right moral action is vindicated by one’s intrinsic values; meaning that people do the right thing (for instance, administering medication) because they have a moral duty to do so, as opposed to motivation by extrinsic values (for instance refraining from administering medication could potential bad consequences like self-harm or harming others) (Markovits, 2011). Therefore, Kantianism involves setting moral rules to give chance to rational argument to achieve universally applicable categorical imperatives, which are used to govern people to have ‘good will’.
Thomas (2015) argued that once the categorical imperatives are set, they become binding and demand adherence in practical application. For instance, allowing adults with mental capacity to give consent to medication is a categorical imperative that is supposed to ensure that mental health practitioners show respect for patient autonomy. Nevertheless, it could be argued that this categorical imperative could lead to potential bad consequences such as self-harm or harm to others if the patients remain untreated for unpredictable psychotic episodes. Therefore, Kantianism presents mental health physicians with an ethical dilemma in their decision-making because they both have a duty to respect patient autonomy and protect a person from harming both self and others.
Nevertheless, Kantianism’s rationale of deontology is hardly enough reason to justify the need for physicians to respect patient autonomy, According to Stohr (2011) Kantianism describes autonomy as a personal choice. In other words, it explains autonomy of the will belongs to the will by which it is considered a law by itself. Kant also claimed that the principle of autonomy regarding a choice in which only choosing in a certain manner that maxims of an individualized choice is part of a universal law in the same violation, forms the sole principle of morals (Stohr, 2011). In other words, Kant believed that people choose autonomously when choosing something because of the pure act of will, as opposed to choosing based on attractiveness of the choice. From Kant’s perspective, autonomy is based on the philosophy that everyone has a worth because of making personal and independent decisions and they have the ability to make informed choices based both on individualized desires and guidance by moral principles. This means that when people rationalize values considered important like theirs, they can make rational decisions. Therefore, the doctor made a rational decision because it was his duty to look after the long-term wellbeing of the patient, who according to him has unpredictable agitation episodes.
Discussion
As highlighted above, autonomy in health care is important because it implies that patients are not to be coerced into medication or treatment if they are capable of making informed decision about their condition (Owen et al., 2013). According to Kantianism physicians have a duty to treat patients to prevent escalation of their conditions, hence providing room for forced treatment. There are specific laws on involuntary psychiatric treatment provided there is genuine concern about the severity of the patient’s condition, which might predispose him or her to endangering self or others (Sjöstrand et al., 2015). Although physicians might justify their moral duty of forced treatment, citing their moral obligation to prevent potential self harm and others, follow-ups on patients subjected to involuntary treatment have indicated that substantial number of patients disapprove the process and cite negative experiences associated with violation of their freedom and personal integrity (Katsakou et al., 2012).
From Peter’s mental examination, it was apparent that he was not suffering from any apparent mental health illness but the doctor decided force him to take psychosis prescriptions, violating not only autonomy of his patient, but also other important aspects such as...