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December 10, 1982

Refusing Treatment in Mental Health Institutions: Values in Conflict

Author Affiliations



edited by A. Edward Doudera and Judith P. Swazey (conference, November 1980), 212 pp, $24, Ann Arbor, Mich, Health Administration Press, 1982.

JAMA. 1982;248(22):3034. doi:10.1001/jama.1982.03330220074046

It is commonplace to preface reviews of multiauthored conference proceedings with warnings of unevenness, repetition, and lack of coherence. This book is an exception. It is a conference report stemming from two recent federal decisions concerning the rights of psychiatric patients to refuse treatment. The participants range from patients to lawyers to psychiatrists to judges, and there is almost an excitement in following the flow of the argument.

The controversy moves from incidents of patient abuse to involved legal tangles to philosophic disputes. The book proper consists of brief, impassioned position papers followed by discussions. The presentations are far from being standard scientific papers, and the authors come marvelously alive in the reading. The expatient who speaks of the anger at years of supposed mistreatment in psychiatric hospitals contrasts sharply with the judge who begins by saying that he is not infallible but quickly persuades us that he could be