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Systematic Reflection Assignment On Involuntary Treatment & Ethical Issues


Task: For this assignment, you will need to reflect on the values, beliefs, opinions and learnings about mental health and illness


5R Reflection Framework
The article explored in this systematic reflection assignment is mainly describing a case study of an insane woman, named Mrs Blanche Duvall, who was charged due to the murder of chief police commissioner Al Miller. Since the insanity is proved already in this article, thus, this is not the main concerned area of this article. There are several other areas of considerations, which can be taken into account as some ‘key issues’. As per my understanding, through considering the overall contexts represented in the article, it can be stated that the two main concerning issues are ‘involuntary treatment’ and ‘ethical issues’. Based on my perspectives, involuntary treatment is one of the most significant issues, as any consent was not obtained from the three ‘partially imbalanced’ patients or from Mrs Duvall before putting them in the Oregon Asylum.

The ethical issue was related to the fact that although the three patients stayed in jail, any criminal charges against them were not issued. Apart from this, the ethical breach was also occurred in case of the justice system, as the three partially healthy patients were staying with the ‘insane’ and criminal-minded Mrs Blanche Duvall, which could be considered as a threat against their lives. Additional to this, another ethical issue was that the jury decided to send the three partially imbalanced patients to the Oregon Asylum, where the treatments required for their improvement is not accessible.

Based on the viewpoint of Hogan, Barton-Bellessa & Lambert (2015, pp. 20-24), most people retain a negative viewpoint about mental health, psychological imbalance, and the services designed for them. However, as being a part of the mental health services, I think that although involuntary treatment is not ethical in any health services, most of the mental patients undergo from this particular phase at least one time during their treatment period. According to the viewpoint of Zhang et al. (2015, p. 100-103), involuntary treatment is required to be restricted for such instances, when the victims can be considered as a serious threat for the surrounding population or themselves.

Unfortunately, after examining this case of systematic reflection assignment, it is observed that involuntary treatment is performed for the three partially imbalanced people, although their mental states are not fully retarded. From this occurrence, I started believing the assessment of conditional elements is essential as, without this, the treatment process might not be completely effective for the victims. Apart from this, I have understood that the lack of engaging patients before admitting them in any service provision is against healthcare ethics (Vandevelde et al., 2017, p. 72-75). Along with this, I think that providing sufficient treatment options to the patients having chances of recovery is a considerable ethical standard of healthcare practice (influenced by Mulvey & Schubert, 2017, p. 250-255).

The media from which I have obtained the case scenario is very old, and therefore, I think that there might be some discrepancies in the information represented by the article author. The language is a little difficult for the common people, due to which the decisional process is not well understood. Apart from this, there is no direct quotation or any other direct link is provided, from which we can see or gain further details about the case scenario. As per my analysis, some gaps are present in the information conveyed in the article, as some necessary information about the pre-murder stage of Mrs Duvall or the actual health condition of the other three people is not mentioned.

On the other hand, if I evaluate the case scenario through considering my background and culture, I can state that there should be some strict provisions for handling the mentally imbalanced criminals, from which involuntary treatment and other ethical issues should be eliminated. I am a Korean girl, named Yooni, age 25, and I belong to a middle-class family. I have seen and learnt from my childhood that there is a large gap in the criminal justice system, especially for the mentally ill population. As in most of the cases, the mentally misbalanced patients stated that they perform crime due to their less static mental condition and due to this reason, the punishment level is very light compared to their crime level (reported from Bandes, 2016, p. 15-17).

As mentioned in the above point within this systematic reflection assignment, being a nurse in mental care services, I think that elimination of involuntary treatment, mislabelling the insanity and partial insanity, as well as avoiding the requirements of patients; all are unethical and considerable issues (influenced from Rowaert et al. 2017, p. 77-80). I think that the people suffering from mental illness and involuntary treatment, like William Winters, John Neimi, and Andrew Svensrud, can be considered as the worst sufferer of such improper service provision, as there is no option available for them to represent their opinion. According to the statement of Walker et al. (2016, pp. 352), representing own perceptions and opinions is a basic human right, which is not given to the three patients involved in this case. They are forced to stay with Mrs Duvall, who already retains a high level of threats for the three people and the other external society. Along with this, I think that it is required to be considered by the jury that without any criminal charges, there is no need to keep the three people in the federal jail.

As per my concept, the issues of involuntary treatment and other ethics are significant in the current healthcare as well as criminal justice system, as proper steps are not taken against the crimes committed by the mentally retarded people. On the other hand, from the case study, I can mention it that sending people for treatment without considering their health requirements is another point of drawback, which is required to be covered by both the healthcare service providers and the authorities of legal justice systems (influenced from Perlin & Weinstein, 2016, p.73). From the analysis, I have learnt that it is essential to maintain the ethics while providing mental health services to the patients, however, it is necessary to differentiate between the disguised mental illness and real issues (Trotter, 2015, p. 56-65).

Apart from this, I have learnt that eliminating the involuntary system and including ethical provisions is necessary for improving the professional healthcare services (influenced by Winkler et al. 2016, pp. 422-424). The situations represented in this case scenario would affect my future learning process, as I would try to provide consents to the partially imbalanced patients as well as consider the other ethics relevant for the mentally ill criminals, like Mrs Duvall. I would also assess the actual health requirements of the patient's before making treatment plans for them. Through this way, I would try to provide my little contribution in improving the mental healthcare system for the ‘insane’ and other mentally retarded population.

Reference List
Bandes, S. A. (2016). Remorse and criminal justice. Emotion Review, 8(1), 14-19. Hogan, N. L., Barton-Bellessa, S. M., & Lambert, E. G. (2015). Systematic reflection assignment FORCED TO CHANGE: STAFF AND INMATE PERCEPTIONS OF INVOLUNTARY TREATMENT AND ITS EFFECTS. Applied Psychology in Criminal Justice, 11(1), 19-39.

Vandevelde, S., Vander Laenen, F., Van Damme, L., Vanderplasschen, W., Audenaert, K., Broekaert, E., & Vander Beken, T. (2017). Dilemmas in applying strengths-based approaches in working with offenders with mental illness: A critical multidisciplinary review. Aggression and violent behavior, 32, 71-79.

Mulvey, E. P., & Schubert, C. A. (2017). Mentally ill individuals in jails and prisons. Crime and justice, 46(1), 231-277.

Perlin, M. L., & Weinstein, N. M. (2016). Said I, but You Have No Choice: Why a Lawyer Must Ethically Honor a Client's Decision about Mental Health Treatment Even If It is Not What S/He Would Have Chosen. Cardozo Pub. L. Pol'y & Ethics J., 15, 73.

Rowaert, S., Vandevelde, S., Lemmens, G., & Audenaert, K. (2017). How family members of mentally ill offenders experience the internment measure and (forensic) psychiatric treatment in Belgium: A qualitative study. International journal of law and psychiatry, 54, 76-82.

Trotter, C. (2015). Working with involuntary clients: A guide to practice. Routledge. Walker, L. E., Pann, J. M., Shapiro, D. L., & Van Hasselt, V. B. (2016). Best practices for the mentally ill in the criminal justice system. Berlin, Germany: Springer.

Winkler, P., Barrett, B., McCrone, P., Csémy, L., Janouskova, M., & Höschl, C. (2016). Deinstitutionalised patients, homelessness and imprisonment: systematic review. The British Journal of Psychiatry, 208(5), 421-428.

Zhang, S., Mellsop, G., Brink, J., & Wang, X. (2015). Involuntary admission and treatment of patients with mental disorder. Neuroscience bulletin, 31(1), 99-112.


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