Author:
Evans Elizabeth A.,Harrington Calla,Roose Robert,Lemere Susan,Buchanan David
Abstract
Involuntary civil commitment (ICC) to treatment for opioid use disorder
(OUD) prevents imminent overdose, but also restricts autonomy and raises
other ethical concerns. Using the Kass Public Health Ethics Framework, we
identified ICC benefits and harms. Benefits include: protection of
vulnerable, underserved patients; reduced legal consequences; resources for
families; and “on-demand” treatment access. Harms include: stigmatizing and
punitive experiences; heightened family conflict and social isolation;
eroded patient self-determination; limited or no provision of OUD
medications; and long-term overdose risk. To use ICC ethically, it should be
recognized as comprising vulnerable patients worthy of added protections; be
a last resort option; utilize consensual, humanizing processes; provide
medications and other evidence-based-treatment; integrate with existing
healthcare systems; and demonstrate effective outcomes before diffusion. ICC
to OUD treatment carries significant potential harms that, if unaddressed,
may outweigh its benefits. Findings can inform innovations for ensuring that
ICC is used in an ethically responsible way.
Publisher
Cambridge University Press (CUP)
Subject
Health Policy,General Medicine,Issues, ethics and legal aspects
Cited by
7 articles.
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