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APHA Scientific Session and Event Listing

Recorded presentation

Steven S. Sharfstein, MD, American Psychiatric Association, Sheppard Pratt, 6501 N. Charles Street, Baltimore, MD MD, 410-938-3401, ssharfstein@sheppardpratt.org

Psychiatry, unlike other medical specialties, is often called on to exercise tasks that are called “social control.” As individuals with mental illness may pose a threat to themselves or others and avoid or refuse treatment, psychiatrists find themselves in the position of involuntarily committing patients or issuing a petition for assisted treatment in the community. These tasks often come up against civil libertarian norms in our democratic society that values freedom and individual autonomy above all else. This paper will review the clinical and social policy case for coercive approaches, introducing the term “caring coercion.” Beginning with the English philosopher Isaiah Berlin, mindful of the words of Thomas Jefferson, this paper will set up the terms for such approaches. Cases will be provided where coercion has been employed and will discuss the public health and civil liberties challenges.

Learning Objectives:

• Despite initial denials by the Administration, it is clear that the human rights of detainees at Abu Ghraib, Afghanistan, and Guantanamo were grossly violated. The violations were so distressing that they resulted in protests from the Judge Advocate Generals of the Armed Forces, from FBI agents, CIA officers, and from at least one Marine unit. Physicians had to have been aware of the torture; some psychiatrists served on teams to advise interrogators; yet, there is as yet no public record of protest by a military physician. Yet, in Chile, South Africa, and Turkey, physicians were prominent in resistance to torture. Why have doctors been silent?

Keywords: Human Rights,

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation