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Chung and Lee: Medicoethical Aspect of Involuntary and Compulsory Admission
Review Article
Journal of the Korean Neuropsychiatric Association

Journal of the Korean Neuropsychiatric Association 2012; 51(3): 107-112.

Published online: 31 May 2012

DOI: https://doi.org/10.0000/jkna.2012.51.3.107

Medicoethical Aspect of Involuntary and Compulsory Admission

Young In Chung, MD, PhD1, Young Min Lee, MD2

1Department of Psychiatry, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

2Department of Psychiatry, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.

Address for correspondence: Young In Chung, MD, PhD. Department of Psychiatry, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro, Mulgeum-eup, Yangsan 626-770, Korea. Tel +82-55-360-2460, Fax +82-55-360-2932, yichung@pusan.ac.kr

Received 6 December 2011       Revised 3 May 2012       Accepted 7 May 2012

Copyright © 2012 Korean Neuropsychiatric Association

Abstract

Involuntary and compulsive admission can damage a patient's autonomy from a medicoethical aspect, but the patient who cannot understand information and explanations from a psychiatrist due to impaired judgment and lacks insight can have impaired judgment in certain circumstances. The decision making of a patient without substantial autonomy in a psychotic or intoxicated state can be justly neglected by the psychiatrist for the patient's sake. Compulsory admission is generally permitted only in case that a patient presents a danger to himself or others, which is not of a benefit to the patient not in danger because of the loss of the opportunity to take appropriate treatment. This enables psychiatrists not to abuse medical paternalism and to protect from the damage to patient's autonomy and civil right. Compulsive admission can be ethically justified to keep the principle of the least restrictive treatment and the patient's right to appropriate treatment. Psychiatrists should help enhance the patient's underestimated autonomy on the basis of the limited paternalism.

Keywords: Autonomy, Ethics, Involuntary and compulsory admission, Paternalism

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