Civil commitment in the treatment of eating disorders and substance abuse: Empirical status and ethical considerations

Abstract

Civil commitment has evolved over the years to reflect the ideas of community, mental health professionals, and law. Individuals with an eating disorder or substance abuse problems can show a high degree of reluctance for treatment while displaying an inability to assess the outcome of their actions. When the safety of the individual clashes with their desire for maintaining the status quo or the individual is incapacitated due to the consequences of an eating disorder or substance use disorder, a discussion of involuntary treatment must be considered. The consequence of those behaviors directs the healthcare provider or family toward coercion. The perception of coercion in civil commitment is complex and not necessarily related to the degree of restriction of freedom. Civil commitment is a legitimate tool in emergent situations when an eating disorder or substance use disorder becomes life threatening. Compulsory treatment can be viewed as being in the best interest of the patient, family, and care provider. Civil commitment as a method to providing treatment is not without its critics or controversies, and a host of ethical concerns accompanies the use of this approach. Although controversial, there is a role for civil commitment in the treatment of eating disorders and substance use disorders.