AUTONOMY VERSUS PATERNALISM IN NON-VOLUNTARY ADMISSIONS

In the doctor-patient relationship, the autonomy of the patient who is considered as partner to the medical procedure is justified by the right to make judgments and decisions based on personal values. In case of vulnerable persons, the paternalism is in conflict with the principle of autonomy and the individual's self-management possibility. It has been noticed that paternalism is quite frequent in the professional ethics, in terms of acknowledgment of the professional authority, and prevents the individual from exercising the autonomy for the achievement of personal goals and interests. Except for specific situations, the interference of others in the free-will selection process is strictly forbidden. The topic of involuntary admission of mentally disordered patients has always involved ethical aspects, but the legal ones should also be considered. The ethical issues arise when the patient is not capable to be aware of the disease. The prerogatives of psychiatric diagnosis can trigger multiple ethical issues from involuntary admission to therapeutic methods. Starting from these aspects, this paper presents a research study aimed to revealing the number of non-voluntary admissions in a mental hospital recorded in 10 years and how this type of admission was justified using criteria, having in view the psychological and social effects of labelling on the mentally disordered patients as well as directly on the individual with regard to the violation of self-determination right. The study also envisaged the management of these cases throughout the hospitalization period, the compliance with the obligation of changing the status of the admission from non-voluntary into voluntary and the self-determination right formally recognized later on by the informed consent.