Department of Social Welfare, Gyeongsang National University, South Korea.
Int J Soc Psychiatry. 2013 May;59(3):217-23. doi: 10.1177/0020764011431543. Epub 2012 Jan 4.
It has long been debated whether coercion can be justified as paternalism in the field of mental health and it is still a continuing issue of controversy today.
This study analyses whether coercive intervention in mental health can be justified by the basic assumptions of paternalists: the assumption of incompetence, the assumption of dangerousness and the assumption of impairment.
This study involved 248 patients: 158 (63.7%) were diagnosed with schizophrenia and 90 (36.3%) were diagnosed with mood disorder. In this study, experiences of coercion were divided into legal status, subjective (perceived coercion) and objective experiences (experienced coercion).
The assumption of incompetence was justified in all three categories of coercion whereas the assumption of dangerousness was not justified in any. The assumption of impairment was not justified in legal status and perceived coercion, but provided a partial explanation to serve as a basis for justifying experienced coercive measures.
It can be noted that mental health experts who support paternalism without question must reconsider their previous methods. Above all, the reason why the assumption of dangerousness was not justified in any of the categories of coercion was because coercive intervention used to prevent harm to oneself and others must be very carefully carried out.
在心理健康领域，强制是否可以被视为家长主义一直存在争议，这仍然是一个有争议的问题。
本研究分析了在心理健康领域，强制干预是否可以通过家长主义的基本假设来证明合理：无能假设、危险假设和损害假设。
本研究涉及 248 名患者：158 名（63.7%）被诊断为精神分裂症，90 名（36.3%）被诊断为情绪障碍。在这项研究中，强制的经验分为法律地位、主观（感知到的强制）和客观经验（经历过的强制）。
无能假设在所有三种强制类别中都是合理的，而危险假设在任何一种强制类别中都不合理。损害假设在法律地位和感知到的强制中没有得到证实，但提供了部分解释，可以作为强制措施合理的依据。
可以注意到，毫不怀疑地支持家长主义的心理健康专家必须重新考虑他们以前的方法。最重要的是，在任何强制类别中，危险假设都没有得到证实，因为为了防止对自己和他人的伤害而进行的强制干预必须非常谨慎地进行。
