Refusing Care

"It has been said that how a society treats its least fortunate members speaks volumes about its humanity. If so, our treatment of the mentally ill may suggest that American society is in many senses inhumane: swinging between overintervention and utter neglect, we sometimes force extreme treatments on those who do not want them, and at other times discharge mentally ill patients who do want treatment without providing adequate resources for their care in the community.". "Refusing Care focuses on the former problem - that of overintervention - asking when, if ever, the mentally ill should be treated against their will. Basing her analysis on both compelling case histories and empirical studies, Elyn R. Saks brings together her experience in law and in psychiatry to explore the dilemmas raised by forced treatment in three contexts: civil commitment, or forced hospitalization for noncriminals; medication; and seclusion and restraints. Saks argues that the best way to solve each of these dilemmas is, paradoxically, to be both more protective of individual autonomy and more paternalistic than current law calls for. For instance, while Saks advocates relaxing the standards for first commitment after a psychotic episode, she would also prohibit extreme mechanical restraints, such as tying someone spread-eagled to a bed. Finally, because of the often extreme prejudice against the mentally ill in American society, Saks proposes standards that, as much as possible, should apply equally to non-mentally ill and mentally ill people alike."--BOOK JACKET.

Beyond its central premise, the book can be read through the connected lenses of Mental Health, Philosophy. Those themes offer useful points of attention as the characters, ideas, or world develop, especially where the book complicates the expectations of its primary category.