In 1990, the US Congress passed the Patient Self-Determination Act (PSDA). It was the first federal state legislation that encouraged the recognition of the patient’s rights to autonomy. American laws and ethics have acknowledged the requirements of this Act. However, the laws and ethics have also identified conditions under which mandating treatment is permitted. The general argument in favor of mandated treatment states that an individual’s rights to autonomy are denied now to lay a foundation for long-term autonomy in the future. This assessment narrates two scenarios (1 & 3).


Scenario 1 presents a patient who wishes to terminate his treatment, but the concerned psychiatrist believes the treatment should be continued. As a consultant in this situation, I permit mandated treatment because American laws and ethics restrict a person’s autonomy if he/she poses potential harm to others. The evidence from this patient’s records already confirms that he had engaged in violent behavior several times and had been to inpatient treatment for the behavior. Moreover, this will be in line with the principle of beneficence because the mandated treatment will protect the rights of the community members by eliminating the chances of the potential harm the patient could cause.

Scenario 3 presents a weak woman who cannot leave the house and wishes to go for psychotherapy, but her daughter refuses to let her. I recommend that the older adult is taken for psychotherapy to show respect for the patient’s right to self-determination. American Psychological Association (2017) also recognizes respect for people’s rights and dignity (Principle E), among others, the right to self-determination. This implies that mandated treatment is unnecessary, as the patient can make meaningful decisions.

Unfortunately, no evidence informs about the difference in the effectiveness of the treatment with or without coercion. This also contributes to the difficulty in evaluating the effectiveness of mandated treatment. Moreover, there needs to be more evidence proving that the centers used for mandated treatment provide a favorable environment or that the range of approaches used is appropriate, safe, and ethical.

In addition, Walker, Cole, & Logan (2009) found that closer examination of patients is needed to select approaches to reduce or eliminate the problematic situation. While many studies have not found evidence for improved outcomes concerning mandated approaches, some have discovered the possibility of harmful results. As a mental health professional charged with cases involving mandated treatment, it is possible to develop the belief that I know what better fits the interest of patients and end up violating some patients’ rights. The client factors that might limit mandatory treatment's benefits include contrary demands; unwillingness to pay attention to training, counseling, and teachings on improvement; and temporary mandatory treatment, as allowed by the rights of autonomy.


Mandating treatment has gained popularity in different parts of the world, but there is still little evidence to confirm its effectiveness, safety, and adherence to ethical standards. Studies that have discovered negative results from the treatment, mainly due to abuse of patients, recommend government intervention in determining evidence-based alternative strategies. Researchers have reported study outcomes such as a lack of improvement and harmful results; hence, the effectiveness of mandated treatment has yet to be fully proven.