Surveying the Geneva impasse: Coercive care and human rights

Int J Law Psychiatry. 2019 May-Jun;64:117-128. doi: 10.1016/j.ijlp.2019.03.001. Epub 2019 Mar 20.


The United Nations human rights system has in recent years been divided on the question as to whether coercive care interventions, including coercive psychiatric care, can ever be justified under UN human rights standards. Some within the UN human rights community hold that coercive care can comply with human rights standards, provided that the coercive intervention is a necessary and proportionate means to achieve certain approved aims, and that appropriate legal safeguards are in place. Others have held that coercive care is never justified. Disagreement over this issue has produced an impasse in the UN human rights system. We survey the impasse with particular attention to the legal arguments that inform the divergent positions. In doing so we introduce a distinction among a variety of different 'abolitionist' positions regarding coercive care, and draw a distinction between 'non-consensual' and 'coercive' treatment. We conclude with three proposals for moving beyond the current impasse.

Keywords: Coercive treatment; Human rights, mental health, consent, psychiatric coercion, psychiatric detention; Involuntary treatment; Non-consensual treatment; United nations convention on the rights of persons with disabilities; United nations human rights committee.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Coercion
  • Human Rights*
  • Humans
  • Informed Consent / legislation & jurisprudence
  • Involuntary Treatment / legislation & jurisprudence*
  • Mental Disorders / therapy*
  • Surveys and Questionnaires
  • United Nations / standards