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The Smallest Cut: The Ethics and (Surprising) Implications of for the Ongoing Genital Cutting Debate.
Kennedy Inst Ethics J
November 2024
This essay applies an ethical analysis of the Jewish religious rite of hatafat dam brit to the ongoing debate on child genital cutting. Recent scholarship on the ethical and legal status of "de minimis" or "symbolic" involuntary genital cutting practices features disagreement over what, if anything, grounds their wrongfulness given that they are (relatively) physically superficial. Hatafat dam brit ("the drawing of covenantal blood") is even less physically intrusive than the most minor of the other practices commonly debated (e.
View Article and Find Full Text PDFClinical, legal and ethical implications of coercion and compulsory treatment in eating disorders: do rapid review findings identify clear answers or more muddy waters?
J Eat Disord
October 2024
InsideOut Institute for Eating Disorders, University of Sydney/ Sydney Local Health District, Sydney, NSW, Australia.
Introduction: This Rapid Review (RR) aimed to assess the current literature over the past decade to determine the prevailing evidence regarding compulsory treatment* in eating disorders (ED). It is hoped that the review will help inform a consensus opinion as to whether this course of action confers significant clinical benefit, and importantly, to whom it should apply. The review also explores alternative options to involuntary care.
View Article and Find Full Text PDFPsychiatrists' experiences of involuntary care in South Africa: dilemmas for practice in challenging contexts.
Med Humanit
August 2024
Psychology, Stellenbosch University, Stellenbosch, Western Cape, South Africa.
Providing for people with psychosocial conditions in crisis is a complex and controversial endeavour that has gained significant attention over the past decade. This increased focus is driven by global calls to reduce coercion, including by the United Nations Committee on the Rights of Persons with Disabilities, who interpret Article 12 of the United Nations Convention on the Rights of Persons with Disabilities in General Comment 1 to advocate for the replacement of substituted decision-making with supported decision-making. Psychiatrists occupy a central role in determining how to care for and respond to individuals with psychosocial conditions in crisis in the midst of these debates.
View Article and Find Full Text PDFInfertility as Trauma: Understanding the Lived Experience of Involuntary Childlessness.
Cult Med Psychiatry
December 2024
Department of Media and Communication, University of Oslo, P.O. Box 1093, Blindern, 0317, Oslo, Norway.
Infertility, to those who are affected by it, is much more than whether one manages (or not) to have a child: it can be a traumatizing experience. Based on a clinical case study that involved one-to-one psychotherapy sessions and semi-structured interviews with six involuntarily childless women living in Norway, this article develops the argument that there is a need to treat infertility as trauma, both conceptually and from the perspective of therapeutic practice. The analysis contributes to our understanding of trauma as a disruptive event that erodes a person's moral agency.
View Article and Find Full Text PDFThe ethics of overriding patient refusals during 5150s and other involuntary psychiatric holds.
Bioethics
October 2024
NYU Grossman School of Medicine, New York, New York, USA.
Involuntary psychiatric holds, such as the 5150 hold in California, allow for an individual to be taken into custody for evaluation and treatment for up to 72 h when they present a risk of danger to themselves. 5150s and other coerced holds present a bioethical tension as patient autonomy is overridden to provide psychiatric care. I discuss two arguments that aim to provide ethical justifications for overriding patient autonomy during 5150 holds: the "clinical benefit" and "lack of capacity" arguments.
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