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Ethics of involuntary commitment to psychiatric hospitalization in Oregon: Current procedures, potential systemic flaws, ethical conflicts, social issues, and systemic alternatives

13 December 2002


Current procedures of involuntary psychiatric commitment in Oregon are discussed. Potential system flaws during initial psychiatric assessment, including police and mental health professional's interpretation of commitment procedures and their ability to assess mental illness, family involvement, psychiatric/behavioral symptoms distracting from full medical evaluations and substance intoxication are reviewed. Defensive psychiatry as a factor of increased commitment to avoid the evaluating physician's civil liability is considered. Sociocultural issues are also discussed, as are re-examination and court proceedings of the committed individual. The interactions of ethical models to consider the ethical conflict of involuntary psychiatric commitment are analyzed. Social issues around dangerousness and implied social control are examined. Finally, systemic alternatives to current commitment procedures in Oregon are reviewed.


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