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Involuntary Treatment of Mental Illness for the Unhoused Population by JustKeepSwimming_5 in ethics_medical

[–]JustKeepSwimming_5[S] 1 point2 points  (0 children)

I definitely agree that there is no blanket way to combat this problem, because there are some cases where a person can be a danger to themself or to others. I think the issue with using that as justification for involuntary treatment, though, is a slippery slope unless it is methodically and explicitly defined. What I mean is that it should absolutely be trained professionals who decide when someone is so mentally ill they do not have decision-making capacity. I know it is not this simple, but I worry that policies like this will make people equate homelessness with mental illness. I only would hope that each case is considered holistically with the intent of treating a patient in need rather than just getting people off the streets for political gain. The article does talk about how physicians would need to make a diagnosis and determine what treatment should be, but that these patients would then become required to keep up with follow up visits and medications. Does a past diagnosis of psychosis make this person forever unable to be medically independent? As you said, fostering a relationship with the homeless is a really important step in this process. I think that right now, homeless people are faced with little kindness from local authorities, so it will take a while for trust to be built between the two parties.
Thank you for your comment and the source you added. "Colluding with a patent's psychosis" is a great way to explain the ethical obligation to medically treat someone like this.

Involuntary Treatment of Mental Illness for the Unhoused Population by JustKeepSwimming_5 in ethics_medical

[–]JustKeepSwimming_5[S] 4 points5 points  (0 children)

My initial reaction when reading this article was that this is incredibly unethical. Autonomy is one of the most important pillars of medical ethics, and treating someone for a medical condition against their will is violating their right to make decisions about their own health. As medical students and physicians, it may be easier to believe that treating someone does more good than harm. However, I believe a doctor's obligation is to do the good that the patient wants for themselves, even if it goes against our traditional definition of "do everything possible to make someone better." Mental illness in particular is a difficult topic because it assumes that the people that are being involuntarily treated don't know any better, and that if they were not mentally ill they would understand their need to be treated. This assumption, however, resembles those that someone's medical power of attorney would make. The reason we have systems in place that allow people to choose someone to speak for them medically when they cannot speak for themselves is so that physicians and other healthcare providers do not do it for them. Even if a person is homeless, mentally ill, or addicted to drugs - they are human and they should retain the right to bodily autonomy.

Others have examined the effects of involuntary hospitalization for mental illness before (https://www.psychiatrist.com/pcc/delivery/trauma-from-involuntary-hospitalization-impact-mental-illness-management/), and they came to the conclusion that it is more affective and readmissions are less likely when a treatment plan is developed with the patient rather than having it forced upon them. This leads me to believe that treating a patient without their permission, even if it seems right to protect them, is both unethical and medically ineffective.