Decision-making capacity and coercive care – law, ethics and the management of non-consenting patients in psychiatric and somatic care

Could it be justified to force individuals into care that they have not consented to?

Legal and ethical literature highlights decision-making capacity (DMC) as the key concept when legitimizing coercive interventions in health care. DMC is however a difficult concept to define and accordingly, difficult to assess in individual patients.

The Swedish legislation on coercive care does not explicitly refer to DMC and is exclusive to persons with mental illness, but coercive practices are commonplace in the health care of other patients, e.g. in dementia care.

Legal support for such interventions are questionable but might be ethically justified.The aim in the project is to investigate the role of patients’ DMC in coercive health care.

The research is conducted through legal and ethical analyses (WP 1-2) and an empirical study (WP 3) about the management of non-compliant patients in psychiatry, dementia care and diabetes care.

A fourth WP will run in parallel with the aim to synthesize the separate disciplinary perspectives.This project enables the unveiling of general issues and patterns in the use of coercion in health care and contributes to discussions on how to establish a more coherent and robust management of non-compliant patients.

The scientific novelty rests in its multidisciplinary and comparative approach.

It is unusual to combine ethical, legal and empirical studies within the field of coercive care in both psychiatric and somatic care.