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December 1973

Decision-Making in the Hospital Community

Author Affiliations

New Haven, Conn
From the Department of Psychiatry, Veterans Administration Hospital, West Haven, Conn, and the Department of Psychiatry, Yale Medical School, New Haven, Conn.

Arch Gen Psychiatry. 1973;29(6):732-735. doi:10.1001/archpsyc.1973.04200060018002

The development of the concept of the therapeutic milieu has changed the social organizations of many contemporary psychiatric wards. This paper discusses some of the polity aspects of these organizations. Examination of the concept of "privileges" enables us to consider the implications of the process of decision-making.

The political organization of the modern hospital ward is shown to be considerably different from that in our wider society. Instead of having achieved democratization, as is often claimed, these wards have resulted in a system of enforced political participation by patients—politicization. The relevance of these polity considerations to the therapeutic task of the hospital is discussed.