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The use of leverage in community mental health: Ethical guidance for practitioners

The use of leverage in community mental health: Ethical guidance for practitioners
The use of leverage in community mental health: Ethical guidance for practitioners
Bckground: leverage is a particular type of treatment pressure that is used within community mental health services to increase patients' adherence to treatment. Because leverage involves practitioners making proposals that attempt to influence patients' behaviours and choices, the use of leverage raises ethical issues.

Aim: to provide guidance that can assist practitioners in making judgements about whether it is ethically acceptable to use leverage in a particular clinical context.

Methods: methods of ethical analysis.

Results: four ethical duties relevant to making such judgements are outlined. These four duties are (1) benefitting the individual patient, (2) benefitting other individuals, (3) treating patients fairly and (4) respecting patients' autonomy. The practical requirements that follow from each of these duties are considered in detail. It is argued that practitioners should determine whether the use of leverage will mean that care is provided in ways that are consistent with the requirements of these four duties, regardless of whether the patient accepts or rejects the terms of the proposal made.

Conclusion: particular attention must be paid to determine how the requirements of the four duties should be applied in each specific treatment scenario, and in making careful judgements when these duties pull in opposing directions.
0020-7640
759-765
Dunn, M
ab0d9496-de22-4cc0-aff0-6bc808eb02ea
Sinclair, J.
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Canvin, K.
b972afd2-1dd9-4fb4-ac79-2e39eb393237
Rugkåsa, J.
aba777de-90dd-4474-a810-152e447bc8c3
Burns, T.
f570817b-410b-491a-a4d1-ed943149ef6b
Dunn, M
ab0d9496-de22-4cc0-aff0-6bc808eb02ea
Sinclair, J.
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Canvin, K.
b972afd2-1dd9-4fb4-ac79-2e39eb393237
Rugkåsa, J.
aba777de-90dd-4474-a810-152e447bc8c3
Burns, T.
f570817b-410b-491a-a4d1-ed943149ef6b

Dunn, M, Sinclair, J., Canvin, K., Rugkåsa, J. and Burns, T. (2014) The use of leverage in community mental health: Ethical guidance for practitioners. International Journal of Social Psychiatry, 60 (18), 759-765. (doi:10.1177/0020764013519083). (PMID:24496210)

Record type: Article

Abstract

Bckground: leverage is a particular type of treatment pressure that is used within community mental health services to increase patients' adherence to treatment. Because leverage involves practitioners making proposals that attempt to influence patients' behaviours and choices, the use of leverage raises ethical issues.

Aim: to provide guidance that can assist practitioners in making judgements about whether it is ethically acceptable to use leverage in a particular clinical context.

Methods: methods of ethical analysis.

Results: four ethical duties relevant to making such judgements are outlined. These four duties are (1) benefitting the individual patient, (2) benefitting other individuals, (3) treating patients fairly and (4) respecting patients' autonomy. The practical requirements that follow from each of these duties are considered in detail. It is argued that practitioners should determine whether the use of leverage will mean that care is provided in ways that are consistent with the requirements of these four duties, regardless of whether the patient accepts or rejects the terms of the proposal made.

Conclusion: particular attention must be paid to determine how the requirements of the four duties should be applied in each specific treatment scenario, and in making careful judgements when these duties pull in opposing directions.

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Dunn et al - The use of leverage - ethical guidance - SUBMITTED - Author's Original
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More information

e-pub ahead of print date: 4 February 2014
Published date: December 2014
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 372255
URI: http://eprints.soton.ac.uk/id/eprint/372255
ISSN: 0020-7640
PURE UUID: ff326248-e9c9-4683-831b-79c26d03db3e
ORCID for J. Sinclair: ORCID iD orcid.org/0000-0002-1905-2025

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Date deposited: 04 Dec 2014 13:17
Last modified: 15 Aug 2019 00:52

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Contributors

Author: M Dunn
Author: J. Sinclair ORCID iD
Author: K. Canvin
Author: J. Rugkåsa
Author: T. Burns

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