‘Coercive’ Measures

  • George Szmukler
Part of the International Library of Ethics, Law, and the New Medicine book series (LIME, volume 45)


This chapter examines a range of treatment pressures in mental health care. Conceptual distinctions can be drawn between interventions commonly termed ‘coercive’. These include ‘compulsion’, ‘coercion’ (narrowly defined), ‘exploitation’, ‘deception’ and ‘inducements’. These may be placed on a rough hierarchy of moral seriousness. Justifications for coercive interventions are discussed and a ‘capacity-best interests’ framework is recommended as applicable across the whole range of interventions. Measures that may reduce the need for coercion are examined, the most promising being certain types of ‘advance statement’ which enhance patients’ involvement in their treatment.

The aim of this chapter is to examine what might broadly be termed ‘coercive’ measures in mental health care. I will examine the distinctions between ‘compulsion’, ‘coercion’ (used in a more precise sense) and ‘inducements’ as types of treatment pressure directed at patients who are reluctant to accept treatment. I will then examine justifications for their use, and finally, means that might lead to a reduction in the necessity for their use.


Mental Health Service Mental Health Care Advance Directive Mental Health Court Compulsory Admission 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Advance Statements


Crisis Cards


Facilitated PAD


Involuntary Outpatient Treatment


Joint Crisis Plans


Mental Capacity Act 2005


Psychiatric Advance Directives


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Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  1. 1.Health Service and Population Research DepartmentKing’s College London, Institute of PsychiatryLondonUK

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