Die ärztliche Einweisung – eine Zwangsmaßnahme in der Medizin

Abstract

Any coercive medical intervention is a massive curtailment of the affected person's freedom that is in direct contradiction to their right to self-determination. This is why any such intervention must be laid on a solid legal and ethical foundation. Any decision to commit a person against their will for medical care will have to be made with due regard for both the institution's medical duty and society's interest in public safety. Any such decision must also involve careful consideration of whether the individual concerned is at acute risk of harming or injuring themselves or others as a result of their mental condition. Involuntary committal may be perceived as extremely insulting by the person concerned, who may feel that their right of self-determination has been violated; and at least for a limited period it will inevitably make them feel that they are not being treated like or regarded as an adult. Hence, the following ethical questions arise: Is it justified to suspend an individual's right of self-determination - if only in terms of their place of residence - by committing them for medical treatment and care? And how can such coercive committal be reconciled with the ethical medical principles of autonomy, beneficence, justice and non-maleficence? There are no stock answers or checklist answers to these questions. Whether a committal is warranted must ultimately be decided on a case-by-case basis by thoroughly assessing, weighting and comparing the various principles and considerations involved.