Assignment 4: A balance between autonomy and beneficence
Yara Langeveld (2760223)
Workgroup 3/subgroup 10 - Health, Globalisation and Human Rights - MPA
27/11/2023
397 words
Informed consent with medical treatments is fundamental in healthcare, but remains a topic of
debate with mental illnesses, such as psychosis1. Specifically, respect for individual autonomy and
obligations of beneficence and public and personal safety collide1. Therefore, it is incorrect to say
that prescribing antipsychotic medication without informed consent is a crime against humanity.
Instead, strict guidelines must be implemented and power must be decentralised in medical
health facilities to avoid abuse of power, while also ensuring beneficence and safety.
Prescribing antipsychotic medication without informed consent cannot be seen as a crime
against humanity, first of all, because it is not realistic to always ensure informed consent of
psychotic patients2,3. For instance, when emergency situations occur, such as acute behaviour
disorders, it is vital that psychiatric treatment is provided timely, as an increased duration of
untreated psychosis is related to worsening of symptoms and earlier relapse2,3. Moreover,
psychiatrists have the obligation of beneficence, meaning they must act in the best interest of
patients, thus, providing the right treatment timely1. Secondly, psychotic patients can form a
threat to themselves and others, for instance when they experience paranoia and become
violent, thereby endangering public and personal safety1. In this case, the right of others not to
be harmed and the right to health of a psychotic patient can take priority over the patient’s right
to refuse psychiatric treatment.
Nevertheless, prescribing antipsychotic medication without informed consent remains an
offense against the autonomy of psychotic patients and disempowers them in their own
treatment4,5. These patients are, namely, not free to choose their own treatment and abuse of
power is difficult to detect, because this power then solely lies with psychiatrists6. However, it
remains important to balance autonomy against beneficence and safety. After all, there are more
cases in which people’s rights are limited to ensure safety, such as mandatory admissions to
mental health institutions or public measures to prevent the spread of infectious diseases, which
also infringes on people’s autonomy. Hereby, strict guidelines and decentralisation of power, for
example through creating small units of experts as secondary accessors of patients’ conditions,
can prevent abuse of power7.
So, prescribing antipsychotic medication without informed consent is not a crime against
humanity, because this can ensure beneficence and public and personal safety1. However, strict
guidelines and decentralisation of power are important for mental health facilities to prevent
abuse of power6,7.
1
Neilson, G. E., & Chaimowitz, G. (2015). Informed consent to treatment in psychiatry. The
Canadian Journal of Psychiatry, 60(4), 1–11. https://europepmc.org/articles/PMC4459249
2
Becker, S. H. D., & Forman, H. (2020). Implied Consent in Treating Psychiatric Emergencies.
Frontiers in psychiatry, 11, 127. https://doi.org/10.3389/fpsyt.2020.00127
Yara Langeveld (2760223)
Workgroup 3/subgroup 10 - Health, Globalisation and Human Rights - MPA
27/11/2023
397 words
Informed consent with medical treatments is fundamental in healthcare, but remains a topic of
debate with mental illnesses, such as psychosis1. Specifically, respect for individual autonomy and
obligations of beneficence and public and personal safety collide1. Therefore, it is incorrect to say
that prescribing antipsychotic medication without informed consent is a crime against humanity.
Instead, strict guidelines must be implemented and power must be decentralised in medical
health facilities to avoid abuse of power, while also ensuring beneficence and safety.
Prescribing antipsychotic medication without informed consent cannot be seen as a crime
against humanity, first of all, because it is not realistic to always ensure informed consent of
psychotic patients2,3. For instance, when emergency situations occur, such as acute behaviour
disorders, it is vital that psychiatric treatment is provided timely, as an increased duration of
untreated psychosis is related to worsening of symptoms and earlier relapse2,3. Moreover,
psychiatrists have the obligation of beneficence, meaning they must act in the best interest of
patients, thus, providing the right treatment timely1. Secondly, psychotic patients can form a
threat to themselves and others, for instance when they experience paranoia and become
violent, thereby endangering public and personal safety1. In this case, the right of others not to
be harmed and the right to health of a psychotic patient can take priority over the patient’s right
to refuse psychiatric treatment.
Nevertheless, prescribing antipsychotic medication without informed consent remains an
offense against the autonomy of psychotic patients and disempowers them in their own
treatment4,5. These patients are, namely, not free to choose their own treatment and abuse of
power is difficult to detect, because this power then solely lies with psychiatrists6. However, it
remains important to balance autonomy against beneficence and safety. After all, there are more
cases in which people’s rights are limited to ensure safety, such as mandatory admissions to
mental health institutions or public measures to prevent the spread of infectious diseases, which
also infringes on people’s autonomy. Hereby, strict guidelines and decentralisation of power, for
example through creating small units of experts as secondary accessors of patients’ conditions,
can prevent abuse of power7.
So, prescribing antipsychotic medication without informed consent is not a crime against
humanity, because this can ensure beneficence and public and personal safety1. However, strict
guidelines and decentralisation of power are important for mental health facilities to prevent
abuse of power6,7.
1
Neilson, G. E., & Chaimowitz, G. (2015). Informed consent to treatment in psychiatry. The
Canadian Journal of Psychiatry, 60(4), 1–11. https://europepmc.org/articles/PMC4459249
2
Becker, S. H. D., & Forman, H. (2020). Implied Consent in Treating Psychiatric Emergencies.
Frontiers in psychiatry, 11, 127. https://doi.org/10.3389/fpsyt.2020.00127
