No abstract

Summary Choice, understanding, appreciation, and reasoning comprise the standard model of decision-making capacity. Difficulties in determining capacity can arise when patients exhibit partial impairment. We suggest that a pragmatic approach, focusing on how capacity status affects the ultimate decision to override the patient’s wishes, can help evaluators resolve difficult cases.

This article seeks to shed light on civil commitment in the context of the opioid crisis, to sketch the existing legal landscape surrounding civil commitment, and to illustrate the relevant medical, ethical, and legal concerns that policymakers must take into account as they struggle to find appropriate responses to the crisis.

No abstract

The systems approach is a widely accepted method for addressing healthcare adverse events. However, when adverse events are behavioral in nature, such as self‐injury or aggression, a systems approach can restrict patient autonomy. We propose guidelines for balancing safety and autonomy considerations when developing systems for behavioral adverse events: interventions that do not limit patient liberty, or that therapeutically address the root causes of behavioral adverse events, should be fully utilized. Clinicians should collaborate with patients when designing systems that may restrict patient liberty. And clinicians should be supported in managing the stress that accrues from working in hazardous environments.