Men in White Coats: Treatment Under Coercion

ISBN : 9780198801047

George Szmukler
264 Pages
138 x 216 mm
Pub date
Nov 2017
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Mental health laws surrounding psychiatric treatment under coercion have remained largely unchanged since the eighteenth century. The grounds for involuntary treatment in psychiatry are first, that the patient has a "mental disorder" that warrants treatment; and second, that the patient needs to be treated in the interests of his or her safety or for the protection of others. Men in White Coats: Treatment under Coercion is an accessible and timely resource on medical treatment under coercion and its justifications. Split into thirteen chapters, George Szmukler examines the current grounds for involuntary treatment of patients with mental disorders. He argues that the existing laws are both discriminatory and morally unacceptable, and that they should be replaced by an entirely different approach for over-riding treatment refusals. Using case studies and real-life experiences, Men in White Coats: Treatment under Coercion discusses how involuntary treatment in psychiatric practice affects patients, their families, and society, and looks to potential solutions to the current legal frameworks surrounding coercion that could be made applicable across all medical specialties and settings.


1 A practice with a very long history
2 Some troubling observations about involuntary treatment
3 The conventional grounds for involuntary treatment are highly problematic
4 Challenges to the orthodoxy
5 How mental health law discriminates against persons with mental illness
6 A law that does not discriminate against people with mental illness
7 On being able to make decisions and making decisions for others
8 A new UN Disability Convention: respect for rights, will and preferences
9 Treatment pressures and coercion
10 Can we reduce the need for coercive interventions?
11 Mental disorder and public protection
12 Emergencies, general medicine, community treatment orders and psychiatric advance statements .
13 Where does this take us?

About the author: 

Professor George Szmukler is a psychiatrist whose main research concerns measures aimed at reducing compulsion and 'coercion' in psychiatric care. A key interest is mental health law reform, particularly the development of non-discriminatory, generic legislation which would apply to all persons, regardless of the cause of the underlying disturbance of treatment decision-making. Past posts have included Dean of the Institute of Psychiatry, King's College London (2001-2006); Medical Director of the Bethlem and Maudsley NHS Trust (1997-1999), then joint Medical Director of the South London and Maudsley NHS Trust (1999-2001); Visiting Professor in the Department of Sociology at the London School of Economics (2005-2014); Associate Director of the NIHR Mental Health Research Network, with lead responsibility for Patient and Public Involvement in research (2007-2015).

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