Can coercion in psychiatry be justified? A theoretical adversarial collaboration approach.

The use of coercion in psychiatry is one of the most controversial issues in modern healthcare. There are clinical, legal and ethical arguments in favour of both the abolition and justification of coercion in psychiatry. The two lines of argument are often diametrically opposed, so further development of the discussion seems difficult. To address this unsatisfactory situation, we have applied the approach of adversarial collaboration to this issue. The two authors represent fundamentally different points of view on the question of the legitimisation of coercion in psychiatry. Through a methodically guided exchange of arguments, numerous consensus hypotheses, dissent hypotheses and general consensus hypotheses with dissent in detail were developed. The main findings include the fact that the antagonists argue from completely different starting points at the core of the argument, namely, general arguments vs. individual clinical cases. In addition, antagonists hold consistent positions on many topics. It can therefore be concluded that both those in favour and those against the abolition of coercion in psychiatry are arguing with good intentions.