Rights against Abolition: how Law and Rights perpetuate Psychiatric Coercition

Soc Sci Med. 2025 Aug 21;384:118509. doi: 10.1016/j.socscimed.2025.118509. Online ahead of print.

ABSTRACT

This paper proposes a critical analysis of the role of law and rights in the use of coercive practices in psychiatry, which are increasing in Global North countries. The first part focuses on rights as a framework for coercion. The development of mental health legislation has not altered the historical criteria for coercive psychiatric practices but has formalized the link between mental health and risk or incapacity, with rights providing the framework for coercion and maintaining the status quo. The second part examines rights as a reason for coercion. Following the recognition of rights in mental health, the right to treatment has taken precedence over the right to consent and refuse care, and over procedural rights. Legislative and judicial initiatives have multiplied in recent years in the name of rights and through a compassionate approach, facilitating increasingly implicit, negotiated, and “consented to” psychiatric coercion practices. The third part analyzes rights as an obstacle to individual, collective, and political mobilization. It examines the barriers individuals face in claiming their rights in court, the impossibility of asserting structural rights violations within the justice system, and the inability to collectivize rights claims, highlighting how implementing marginalized groups’ rights contradicts the legal system’s foundations. Finally, by monopolizing and directing the struggle concerning psychiatric coercion, rights prevent the denunciation of the structural issues at its core.

PMID:40961638 | DOI:10.1016/j.socscimed.2025.118509