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Ethical Values and Involuntary Commitment: A Decision-Making Model for Consulting Clinicians

Crisis clinicians are often called upon to consult with physicians in emergency departments on cases in which patients are experiencing psychological crises. The determination of whether the patient is a danger to oneself or others is the criterion by which patients are either admitted for treatment voluntarily, involuntarily, or discharged. When the circumstances of the case indicate that voluntary treatment is not acceptable to the patient, the physician and clinician are left in a dilemma that is shaped by ethical, theoretical, and clinical factors that are unique to the medical and psychological professions. A decision-making model is proposed in which an attempt is made to aid the clinician in making sound ethical and clinical decisions relative to the involuntary commitment of the client.