[Ethical conflicts in involuntary treatment of schizophrenic patients; decision-making and in influential factors in three prototype cases]

Abstract

Three case reports of patients with schizophrenia were presented to a sample of 520 persons (25.1% psychiatrists, 3.7% psychologists, 8.1% social workers, 14.6% nurses, and 48.6% others). The decisions for involuntary admission to a psychiatric hospital and involuntary treatment were questioned. In case 1 (young man, first episode, delusions, extreme social withdrawal), 71.7% supported admission to hospital and 62.7% were in favor of neuroleptic treatment. In case 2 (woman with disorganized syndrome beating her 74-year-old mother), 84.6% supported hospitalization and 78.8% neuroleptics. In case 3 (relapsed multi-episode patient, increasingly neglected, delusional, and socially withdrawn), 56.3% supported hospitalization and 52.7% neuroleptics. Generally, psychiatrists' decisions were very similar to those of other professionals and laypersons, while social workers more often rejected involuntary treatment. After professional status, multivariate analyses revealed older age as the most significant variable for support of involuntary treatment. Frequency of experience with mentally ill persons were only weak predictors or not significant.