Hope Reese interviews Dr. Christine Montross, author of Falling Into the Fire, about the ethics of mandatory psychiatric treatment:
Kendra’s Law, enacted in several states after an untreated schizophrenic man pushed a woman to her death on a subway platform in New York, is a controversial measure that makes outpatient treatment mandatory. What do you think of the ethics here?
Taking away someone’s autonomy is always an uneasy balance. Nonetheless, in my work with the chronically and persistently mentally ill, I’ve all too often seen how periods of treatment nonadherence can extend patients’ symptoms and suffering, and can sometimes put them in real danger. I’ve treated many patients who have been tormented by paranoia or besieged by hallucinations, and without treatment their symptoms simply do not remit. Once court-ordered treatment is implemented, I see people begin to emerge from deep distress, often with great relief because their fear-inducing symptoms diminish, their quality of life begins to increase dramatically. I write about this in Falling Into the Fire in terms of involuntary hospitalization. Compelling patients to obtain treatment is a tool we must use sparingly and only when appropriate to do so. But refusing to ever compel treatment is short-sighted, as doing so can allow a patient’s illness and suffering to persist under the guise of preserving autonomy.
The Dish 