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Life, liberty and the therapeutic relationship: examining the place of compulsory treatment in modern psychiatry

Objectives: Compulsory treatment in psychiatry is controversial and its use has been increasingly critiqued following the United Nations Convention on the Rights of Persons with Disabilities in 2006. This essay seeks to explore whether the restriction of personal liberty and autonomy that compulsory treatment requires can be justified on ethical or medical grounds. Conclusions: Compulsory treatment is not without potential harms to the doctor–patient therapeutic relationship and patient engagement with mental health services. However, we contend that the clinical and societal benefits of compulsory treatment justify its practice and that, paradoxically, compulsory treatment is necessary for the restoration of a patient’s autonomy rather than its dispossession.