Party or Patient?
Discursive Practices Relating to Coercion
in Psychiatric and Legal Settings
isbn 978-91-972690-4-9, 360 sidor
Compulsory psychiatric care involves a variety of intricate ethical and practical considerations. What are the potential benefits of coercive intervention? How large are the costs of disregarding the stated opinion of a patient? To what extent should the interests of relatives, neighbours and others be taken into account?
Drawing on observations from unique ethnographic fieldwork, Stefan Sjöström tells a story of how psychiatric staff in everyday activities make decisions about involuntary admission, medication and restraints. The author then turns to the court hearings which are required by a new law-The Compulsory Psychiatric Care Act (LPT).
The differences in tasks and tradition between medical and legal institutions give rise to an expectation that the legal evaluation of psychiatric decision-making is problematic. How do chief psychiatrists strike a balance between the contrasting roles of helper and prosecutor? How does an attorney represent a client whom she finds to be incapable of making rational decisions? How can judges and attorneys make sense of the complex expert evaluations which are based on concrete clinical practice?
The relevance of this book goes beyond the Swedish context, since there are considerable similarities between Western countries concerning both compulsory care legislation and psychiatric practice.
* * *
"Det är frågan om två kulturer som möts. /.../ De två 'världarna' beskrivs med en närhet och detaljrikedom som gör Sjöströms bok till en mycket fascinerande läsupplevelse." (Tore Nilstun, Socialmedicinsk tidskrift nr 3 1998)
"... ett välkommet bidrag till vår kunskap om hur psykiska sjukdomar konstrueras från lekmannabegrepp till professionella beteckningar och hur den psykiatriska vården och tvångsvården administreras i praktiken. Den kan därför rekommenderas för såväl psykiatrisk som social och juridisk fortbildning. /.../ ...ett tvärvetenskapligt pionjärarbete som säkert kommer att röna även internationellt intresse." (Leif Öjesjö, Läkartidningen, volym 95, nr 13, 1998)
"... an interesting and insightful book, based on a study which is well designed and executed. It also provides a useful backdrop for beginning to explore the way in which coersive measures apply in non-hospital contexts." (Anne Rogers, Sociology of Health and Illness/ a journal of medical sociology, nr 20, 1998, page 410-411)
"Party or Patient will quickly find its way to the bookshelves and course reading-lists in a number of disciplines. /.../ ...a relevant and significant contribution to the international literature. /.../ Sjöström´s method of displaying the practical knowledge and discretionary power of institutions, while at the same time demonstrating the vicissitudes of an individual who traverses these institutions, is exemplary. Well crafted, theoretically penetrating, with a methodology that is made transparent, and a valuable discussion of the ethics of fieldwork, Party or Patient is a model ethnographic study of what is, perhaps, one of the most intrusive exercises of state power. (Rob Barett, AJS -American Journal of Sociology, January 1999, 104:4)
"Indeed, this book is of interest to legal scholars primarily because it documents how unelected and scarcerly accountable private actors interpret and implement the law." (Judith Lynn Failer, The Law and Politics Books Review, vol 8 no 1, pp72-74)
"..an interesting and insightful book, based on a study which is well designed and executed. It also provides a useful backdrop for beginning to explore the way in which coercive messures apply in non-hospital contexts. (Anne Rogers, Sociology and illness, 1998)