Mental Illness and Ethical Implications for a Special Needs Population
Subsets of the world’s population have historically been vulnerable to abuse and discrimination. People with mental illness, intellectual disabilities or other cognitive impairment, as well as traumatized refugee populations, present with special needs and specific ethical implications for their treatment. This course complements the modules “Clinical Ethics and Decision-Making” and “Involving Human Subjects” and will explore ethical questions underlying issues facing patients with psychiatric or neuro-cognitive conditions such as involuntary commitment, treatment over objection, court ordered addiction treatment, capacity assessment, and legal guardianship. Benevolent paternalistic principles guiding care will be discussed, but also the historical development of these in Western nations and the political misuse of psychiatric diagnosis and detention for the purposes of obstructing fundamental human rights of groups and individuals in certain societies will be touched upon. The course will further highlight subgroups in these vulnerable populations that have become the focus of recent public debate, namely prisoners with severe mental illness and refugees. The frequent absence of adequate psychiatric treatment in prison places this groups at additional risk for abuse and exacerbation of symptoms and legal problems. The prevalence of exposure to torture and psychological trauma in refugees poses a special need for care and a risk for being re-traumatized during the asylum process and in detention centers.
Nina B.L. Urban, M.D., Assistant Professor, Department of Clinical Psychiatry, New York State Psychiatric Institute/Columbia University Medical Center, New York, NY.
Click here to view a video about Nina Urban’s lecture.