Clinical ethics

Coercion and pressure in psychiatry: lessons from Ulysses

Maastricht University, Faculty of Health, Medicine and Life Sciences, Department of Health, Ethics and Society/Metamedica, Research School Caphri, Maastricht, The Netherlands

Correspondence to:
Ron Berghmans, Maastricht University, Faculty of Health, Medicine and Life Sciences, Department of Health, Ethics and Society/Metamedica, Research School Caphri, PO Box 616, 6200 MD Maastricht, The Netherlands; r.berghmans{at}zw.unimaas.nl

Coercion and pressure in mental healthcare raise moral questions. This article focuses on moral questions raised by the everyday practice of pressure and coercion in the care for the mentally ill. In view of an example from literature—the story of Ulysses and the Sirens—several ethical issues surrounding this practice of care are discussed. Care giver and patient should be able to express feelings such as frustration, fear and powerlessness, and attention must be paid to those feelings. In order to be able to evaluate the intervention, one has to be aware of the variety of goals the intervention can aim at. One also has to be aware of the variety of methods of intervention, each with its own benefits and drawbacks. Finally, an intervention requires a context of care and responsibility, along with good communication and fair treatment before, during and after the use of coercion and pressure.

Keywords: ethics; coercive treatment; pressure; mental illness; Ulysses

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