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Citation
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Hare SM, Benzer S, Knight SR, Rouhakhtar PR, Reeves GM, McDonald K, RachBeisel J. Psychiatr. Serv. 2023; ePub(ePub): ePub. |
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Abstract
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Involuntary civil commitment (CC) is a legal intervention in which a person experiencing symptoms of a serious mental illness (e.g., a mental illness that causes serious impairment) is court ordered to receive supervised inpatient care. Although CC laws vary by state, many of them share common features. For patients to be involuntarily hospitalized, most CC laws specify that they must present a danger to the life or safety of themselves or others. Every patient has the right to a formal hearing in which a hearing official considers all evidence and testimony and may order release from care unless specified criteria have been met.
To limit COVID-19 exposures, many courts rapidly adapted CC hearings from an in-person to a virtual (videoconferencing) format. The virtual format allows the patient to be in one location (often at the hospital) and the hearing official (often a judge) to be in another location; the patient's attorney may also attend from another location. Many courts are opting to continue to conduct fully virtual hearings in the aftermath of the COVID-19 pandemic, and this decision raises important questions: How should CC hearings be conducted now that in-person gatherings present less of an imminent threat to personal health and safety? Do virtual hearings present any obstacles for officials as they weigh all the evidence to make a fair determination of whether the patient meets legal requirements to be retained in hospital care?
Although prior publications have discussed the ethics of virtual CC hearings (1-3), we argue that this literature presents a one-sided view and highlights the convenience of virtual hearings for legal officials and counselors (1-3). What is needed is a thorough ethical analysis of the benefits versus costs (or risks or challenges) of virtual CC hearings. In this Viewpoint, we contend that virtual hearings may present challenges to making fair and accurate safety determinations and may contribute to both overuse and underuse of CC. In the final section, we discuss the fact that our opinions are largely influenced by our own (local) experiences and how this local lens may limit generalizability of our claims to medical systems and courts in other geographic regions...
Language: en |