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An empirical ethical analysis of community treatment orders within mental health services in England

An empirical ethical analysis of community treatment orders within mental health services in England
An empirical ethical analysis of community treatment orders within mental health services in England
Community treatment orders are a legal mechanism to extend powers of compulsion into outpatient mental health settings in certain circumstances. Previous ethical analyses of these powers have explored a perceived tension between a duty to respect personal freedoms and autonomy and a duty to ensure that patients with the most complex needs are able to receive beneficial care and support that maximises their welfare in the longer-term. This empirical ethics paper presents an analysis of 75 interviews with psychiatrists, patients and family carers to show how these ethical considerations map onto the different ways that community treatment orders are used and experienced in practice. A complex and nuanced account of how the requirements to respect patients’ autonomy, to respect patients’ liberty and to act beneficently should be interpreted in order to make judgements about the ethics of community treatment orders is presented. The article argues that, due to such complexity, no general ethical justification for community treatment orders can be provided, but a justification on the basis of the promotion of patients’ autonomy could provide an ethical reason for community mental health practitioners to make use of a community treatment order in some limited circumstances.
1477-7509
130-139
Dunn, Michael
aa8b359a-49a9-426b-879c-894ccb4b25e6
Canvin, Krysia
50e7de06-3225-471b-8ce9-7ef4a9d33e80
Rugkåsa, Jorun
c01a5322-1e15-4c99-86cf-506e0ec2c16f
Sinclair, Julia
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Burns, Tom
83cdb35a-a24d-4ee1-bc2d-ce69f5d10ca7
Dunn, Michael
aa8b359a-49a9-426b-879c-894ccb4b25e6
Canvin, Krysia
50e7de06-3225-471b-8ce9-7ef4a9d33e80
Rugkåsa, Jorun
c01a5322-1e15-4c99-86cf-506e0ec2c16f
Sinclair, Julia
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Burns, Tom
83cdb35a-a24d-4ee1-bc2d-ce69f5d10ca7

Dunn, Michael, Canvin, Krysia, Rugkåsa, Jorun, Sinclair, Julia and Burns, Tom (2016) An empirical ethical analysis of community treatment orders within mental health services in England. Clinical Ethics, 11 (4), 130-139. (doi:10.1177/1477750916657654).

Record type: Article

Abstract

Community treatment orders are a legal mechanism to extend powers of compulsion into outpatient mental health settings in certain circumstances. Previous ethical analyses of these powers have explored a perceived tension between a duty to respect personal freedoms and autonomy and a duty to ensure that patients with the most complex needs are able to receive beneficial care and support that maximises their welfare in the longer-term. This empirical ethics paper presents an analysis of 75 interviews with psychiatrists, patients and family carers to show how these ethical considerations map onto the different ways that community treatment orders are used and experienced in practice. A complex and nuanced account of how the requirements to respect patients’ autonomy, to respect patients’ liberty and to act beneficently should be interpreted in order to make judgements about the ethics of community treatment orders is presented. The article argues that, due to such complexity, no general ethical justification for community treatment orders can be provided, but a justification on the basis of the promotion of patients’ autonomy could provide an ethical reason for community mental health practitioners to make use of a community treatment order in some limited circumstances.

Text
Dunn et al - Empirical ethical analysis of CTOs in England - Clinical Ethics - Accepted Manuscript
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e-pub ahead of print date: 7 July 2016
Published date: 1 December 2016
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 410604
URI: https://eprints.soton.ac.uk/id/eprint/410604
ISSN: 1477-7509
PURE UUID: dff8249b-636a-42c9-9a84-eea7e7ac9e2b
ORCID for Julia Sinclair: ORCID iD orcid.org/0000-0002-1905-2025

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Date deposited: 09 Jun 2017 09:12
Last modified: 10 Dec 2019 01:53

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