The decision making process including assessment of ethical principles in the commitment of police-referred, psychiatric patients.

Objectives: to identify determinants for psychiatric commitment and analyse physicians' assessment of ethical principles concerning interested groups on the decision to commit a psychiatric patient.

Design: a prospective physician survey concerning commitment of patients brought by police to a psychiatric emergency unit.

Patients: Two hundred consecutive, police-conveyed patients.

Outcome Measure: psychiatric commitment.

Predictor Variables: psychiatric symptoms, diagnosis, risk for suicide/violence, ethical benefits/costs, physicians' gender, age and education.

Results: 56% of the patients were committed. Commitment correlated with a low score on the function assessment scale, patients' negative/ambivalent attitude towards hospitalisation, and diagnosis of psychosis or organic mental disorder. More specialists believed hospitalisation to fulfil patients' autonomy and benefit patients, families, and the community.

Conclusions: dangerousness was often not identified as an indication for commitment. Assessments of commitment's ethical benefits for a patient compared to costs for violation of the patient's autonomy often gave more weight to the former.