
Contents
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A spectrum of ‘treatment pressures’ A spectrum of ‘treatment pressures’
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1. Persuasion 1. Persuasion
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2. Interpersonal leverage 2. Interpersonal leverage
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3. Inducements (or offers) 3. Inducements (or offers)
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4. Threats 4. Threats
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5. Compulsion 5. Compulsion
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‘Subjective’ versus ‘objective’ accounts of coercion ‘Subjective’ versus ‘objective’ accounts of coercion
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Exploitation and ‘unwelcome predictions’ Exploitation and ‘unwelcome predictions’
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‘Inducements’ in the context of health care ‘Inducements’ in the context of health care
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‘Threats’ in the context of health care ‘Threats’ in the context of health care
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Conditional treatment in the community Conditional treatment in the community
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Conditional treatment in hospital Conditional treatment in hospital
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Justifying treatment pressures and coercion Justifying treatment pressures and coercion
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References References
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12 Emergencies, general medicine, ‘community treatment orders’, and ‘psychiatric advance statements’
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9 Treatment pressures and ‘coercion’
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Published:November 2017
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Abstract
In this chapter, compulsion is presented in a broader context of ‘treatment pressures’. A hierarchy of pressures is presented, each increment moving in a more coercive direction. It comprises persuasion; interpersonal leverage; inducements; threats; and compulsion. The last has been dealt with in previous chapters. The distinction between inducements and threats turns on whether rejecting a conditional proposal—if you do X, I will do Y; if you don’t, I will do Z—results in the subject being ‘worse off’ or not according to a ‘moral baseline’. Threats involve proposals making the person worse off and represent ‘coercion’; inducements, where rejection does not make the person worse off, do not. However, in the context of mental health care, inducements can be problematic. While threats, often covert, are very common in mental health care, they are considered unethical. Perhaps, if regulated, they could have a place. Justifications, across the board, can follow a ‘capacity–will and preferences’ approach.
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