| Abstract [eng] |
Involuntary hospitalization (IH) and involuntary treatment (IT) are among of the most restrictive measures in health care. They involve the admission and treatment of individuals without their consent. It is justified as mandatory measure to ensure patients own and other safety, IH raises ethical concerns regarding patient autonomy, human rights, and treatment outcomes. Across the European Union and non-Union states, involuntary treatment is governed by very diverse legal frameworks. Inside Europe there is a lot of variation in admission criteria and especially concerning judicial oversight and its role relating to the treatment. Additionally, how much and in what ways medical doctors have a role concerning IT varies from country to country. This literature review examines the legal, medical, and ethical dimensions of involuntary hospitalization in the European Union context, with a particular focus on three countries with distinct approaches to IT: Finland, Germany, and Spain. The findings show fundamental differences in how and when involuntary psychiatric treatment is being used. Finland’s approach is quite medically centered in the international scale. They require several psychiatric examinations before involuntary admission is legally ratified. Spain, in some ways opposite of Finland when comparing in EU, has a system in place where the main emphasis is on judicial authorization. Spanish courts have a great role during the actual admission process and the decision of ordering the treatment. Germany with its decentralized system, gives responsibility about the specifics of indications and laws around IT and the initial admission to every German state. Most of the states lean towards a judicial centered approach. In this review ethical issues such as adverse outcomes of Involuntary treatment and Involuntary hospitalization IH, are discussed. Involuntary hospitalization itself does not necessarily include any treatment. Also, alternatives for coercive involuntary treatment are brought up and reviewed. Involuntary treatment has been and still is a complex and controversial topic in the medical world, by having many legal, medical, and ethical considerations. The variations observed across Finland, Germany, and Spain reflect broader debates on the extent to which coercion should be used in psychiatric care. Although efforts to minimize coercion 3 and prefer alternative interventions continue, challenges persist in ensuring that IA policies balance patient rights with effective mental health treatment. Further research is needed to evaluate the long-term impact of involuntary treatment and to develop more effective, ethically sound alternatives to coercion in psychiatric care. |
