Question

Why is nonconsensual, compulsory treatment widely accepted in mental healthcare? Why are many in the medical and bioethics community so certain that the “insane” are undoubtedly unfit to choose for themselves? Who is to say? Who is to decide what is the most whole/beautiful/meaningful/ “right” existence of another?

 

* Thinking specifically about nonconsensual electroconvulsive therapy (ECT) in schizophrenic patients, some who deny their diagnosis and treatment. See the case PBU & NJE v Mental Health Tribunal from 2018 in Victoria. Essentially, the patients won and were freed from forced treatment. For those on the side of patient advocacy and autonomy, this was good news. However, this ruling upset some psychiatrists and bioethicists.

Question

Can the mentally ill, as certain medical systems see them, make rational, autonomous decisions for themselves? Do certain emotions halt capability to reason? Can anyone make autonomous decisions for themselves? Or are we all embedded in and influenced by altered/unaltered choice/default design?