Ethics and Normativity in Non-Voluntary Hospitalization

FORMAT | Presented paper

LANGUAGE | English

HOW TO CITE| SANDU, Antonio, & Frunză, A. (2015). Ethics and Normativity in Non-Voluntary Hospitalization. Prezentată în cadrul Sesiunii Plenare la 7th LUMEN International Conference – Multidimensional Education and Professional Development. Ethical Values – MEPDEV 2015, 12th – 14th November 2015, Târgoviște, România.

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ABSTRACT:

This paper aims at emphasizing some analysis frameworks from bioethical perspective on the non- voluntary hospitalization of the psychiatric patients which was not decided based on a court decision and / or a forensic report. The case study concerns a case in which the Romanian state was condemned by the ECHR for failing to follow the procedures agreed at European level on non-voluntary hospitalization nor was obtained a credible informed consent from the patient. In reasoning the decision for this case, the ECHR pointed out the seriousness of the fact that, in fact, it has been a cooperation of several state institutions, including a psychiatric hospital, the Police and the Prosecution. The case has considered limiting freedom of movement of persons – by non-voluntary hospitalization – at the same time endangering the health of patients by prescribing a medication specific to particularly aggressive disease that may have serious psychiatric side effects. ECHR considers that to perform such treatment would have been necessary to guarantee the possibility of a medical counter expertise. The case can be considered as a limitation of freedom of conscience, as the alleged reason of using of non-voluntary hospitalization by the parents of patient – major patient at the date of hospitalization – was the patient’s appurtenance to a group – legally composed in Romania, but very disputed in terms of social, political and religious beliefs, a group who was dealing with an extremely negative public image in that period, and also with a very supported negative media campaign. This group was promoting a series of eastern spiritual practices of yoga.
This article is not limited to the specific remarks for medical ethics, but we are interested in Kantian Deontic ethical perspective, compared to the utilitarian ethics and that specific to the ethics of care. We see that all parties involved can have a number of moral reasons to justify their conduct. Our position is that non-voluntary hospitalization cannot be justified as a means of social control, except if an expert committee considers its necessity, and a court decides irrevocably the hospitalization. It also proposes that the pursuit, from the community perspective enforcement of non-voluntary hospitalization, to be made jointly by the probation services – by Community psychiatry specialized staff to be hired in as probation counselor.

KEYWORDS:

Non- voluntary hospitalization; ethical perspective; ECHR; informed consent; psychiatric patients.