Journal of Bioethical Inquiry

, Volume 8, Issue 1, pp 87-93

First online:

One Flu Over The Cuckoo’s Nest: Comparing Legislated Coercive Treatment for Mental Illness with that for Other Illness

  • Christopher James RyanAffiliated withDiscipline of Psychiatry and Centre for Values, Ethics and the Law in Medicine, University of Sydney Email author 

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Many of the world’s mental health acts, including all Australian legislation, allow for the coercive detention and treatment of people with mental illnesses if they are deemed likely to harm themselves or others. Numerous authors have argued that legislated powers to impose coercive treatment in psychiatric illness should pivot on the presence or absence of capacity not likely harm, but no Australian act uses this criterion. In this paper, I add a novel element to these arguments by comparing the use of the harm to others justification for coercive treatment in mental illness with its use in illness due to infectious disease, and suggest a double standard applies. People with mental illness are subjected to coercive treatments at levels of risk to others far, far lower than would precipitate coercive treatment in people with influenza. In effect, this element of mental health legislation represents an example of sanism—state-sanctioned discrimination against people with mental illnesses.


Mental competency Informed consent Mental disorders Ethics Legislation Human rights Dangerous behaviour