The Normative Threshold for Psychiatric Civil Commitment
28 Pages Posted: 12 Jan 2011 Last revised: 20 Jan 2011
Date Written: 2010
There is an ethical debate about whether mental health professionals should predict dangerousness. One powerful objection involves considering the nature and scope of what is being predicted. Dangerousness is a bifurcated concept with a descriptive component, corresponding to risk factors and their relation to violence, and a normative component, corresponding to a moral and legal judgment that sufficient risk exists to justify involuntary confinement. The normative judgment is exclusively reserved for legal decision makers, although due process constitutionally constrains these decisions. This article uses decision theory to show the general effects of due process on setting a minimal threshold of risk necessary to justify involuntary civil commitment. It then demonstrates the corollary of applying these effects to the results of the foremost actuarial tool, under varying base rate assumptions. It concludes that the involuntary confinement of only the highest risk individuals is legally justified.
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