[Application of the Act Special Admissions in Psychiatric Hospitals; balance between respect for autonomy and acting in the patient's best interest].

Three years after the implementation of the Dutch Act on Compulsory Admission to Psychiatric Hospitals an evaluation was made. It shows that the law has reinforced the patients' rights to self-determination, but that actual practice is not yet fully according to the law. For the latter the reporters blame the complexity of the law and the inadequate manner in which the law was introduced. An evaluation of the effects of a similar law in the USA puts this issue in a different light. It shows that caregivers and judges do not let the patient's rights to autonomy prevail if this is not in the patient's best interests. The right to self-determination, expected in the sixties and seventies to become a revolution in psychiatry appears to be merely 'a near-revolution'. The moral importance of caring for a psychiatric patient outweighs the respect for his or her right to self-determination.