There are three lines of argument in defence of coercive treatment of patients with mental disorders: arguments regarding (1) societal interests to protect others, (2) the patients' own health interests, and (3) patient autonomy. In this paper, we analyse these arguments in relation to an idealized case, where a person with a mental disorder claims not to want medical treatment for religious reasons. We also discuss who should decide what in situations where patients with mental disorders deny treatment on seemingly rational grounds. We conclude that, in principle, coercive treatment cannot be defended for the sake of protecting others. While coercive actions can be acceptable in order to protect close family and others, medical treatment is not justified for such reasons but should be given only in the interest of patients. Coercive treatment may be required in order to promote the patient's health interests, but health interests have to waive if they go against the autonomous interests of the patient. We argue that non-autonomous patients can have reasons, rooted in their deeply-set values, to renounce compulsory institutional treatment, and that such reasons should be respected unless it can be assumed that their new predicaments have caused them to change their views.

译文

捍卫对精神障碍患者的强制治疗有三个论点: 关于 (1) 保护他人的社会利益,(2) 患者自身的健康利益和 (3) 患者自主权的论点。在本文中,我们分析了与理想化案件有关的这些论点,在该案件中,有精神障碍的人声称出于宗教原因不想接受治疗。我们还讨论了在精神障碍患者以看似合理的理由拒绝治疗的情况下,谁应该决定什么。我们得出的结论是,原则上不能为了保护他人而捍卫强制性待遇。虽然为了保护亲密的家人和其他人,强制行动是可以接受的,但由于这些原因,医疗是不合理的,而应该只为了患者的利益。为了促进患者的健康利益,可能需要强制治疗,但是如果健康利益违背了患者的自主利益,则必须放弃。我们认为,非自主患者可以有理由放弃强制性的机构治疗,这些理由植根于他们根深蒂固的价值观,除非可以假设他们的新困境导致他们改变了观点,否则应该尊重这些理由。

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