Coercion And Autonomy Case Study

Consent, Coercion and Autonomy in the Treatment of
Substance Abuse and Addiction
Brianna J. Westover
Delaware Technical and Community College

Historical Implications
Addict. The word itself carries with it an enormous stigma. Just over 100 years ago in 1914, the Harrison Act banned the use of opiates and cocaine. Four years later, alcohol prohibition followed, and in 1934, the Marijuana Stamp Act was enacted, prohibiting that substance as well. (American Civil Liberties Union, 2015) The result of this new judicially prohibitive environment was increased crime and incarceration, as evidenced in a short New York Times article from 1926 indicating, “35% of Federal Prisoners are serving sentences for violation of the anti-narcotic law of the

Autonomy is defined in Ethics of healthcare: A guide for clinical practice, 3rd Edition as the freedom of the individual “to choose and implement her own decisions, free from deceit, duress, constraint, or coercion” (Edge & Groves. 2006. p. 60). The extent to which addicts are considered competent “autonomous agents” is the true question here, with rights to informed consent and refusal of treatment. What are the criteria for employing the use of coercion and are addicts competent to make decisions regarding their

Some commonly professed motives are lower levels of psychological distress, family and social problems, and prior successful treatment experience (Anglin, Hser, Maglione, & Polinsky, 1998). Some come into an Emergency Department with serious acute conditions resulting from their substance use. In cases where the patient is incapacitated, implied consent is applied and lifesaving treatment begins immediately to alleviate the effects of the drugs. The practitioner and patient discuss continued care and substance abuse treatment when the patient recovers from immediate danger. Some patients report with less threatening illnesses in a more conscious state of mind. Here, the practitioner assesses the patient’s risk to themselves or others. These situations are where a knowledge of medical ethics is