Psychology/Psychiatry

Mental Illness Doesn't Cancel Your Right to Say No

Informed consent applies to psychiatry too.

Jeffrey A. Singer and Adam Omary | 10.14.2026 10:36 AM

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If a treatment can improve your health, does that give the government the right to force it onto you? Should the state compel people with diabetes to take insulin, patients with hypertension to take their medications, or people with obesity to lose weight?

Most Americans would recoil at such proposals. Yet when it comes to people diagnosed with psychiatric disorders, many people seem willing to make an exception.

A physician who administers treatment to a competent adult against the patient's will violates one of medicine's most fundamental ethical principles: informed consent. Why should that principle carry less weight when the doctor is a psychiatrist? Yet in a recent City Journal article, Stephen Eide and Valerie Franchitti of the Manhattan Institute argue that public support for involuntary psychiatric treatment reflects a welcome recognition of its potential benefits.

Strangely, the article entirely avoids the concept of informed consent. Where it acknowledges any limitations to involuntary treatment at all, it considers only the possibility that coercive treatment may increase stigma against mental illness.  

But the more fundamental objection is liberty. A psychiatric diagnosis does not extinguish your right to control your body. Competent adults have the right to decide what substances they consume, which medical treatments they accept, and what risks they take, even when others consider their choices unwise or self-destructive. As the psychiatrist Thomas Szasz wrote in 1997, "I oppose involuntary psychiatric interventions not because I believe that they are necessarily 'bad' for patients but because I oppose using the coercive apparatus of the state to impose psychiatric relations on persons against their will."

Eide and Franchitti write, "The public is right to suspect that involuntary treatment can be effective." They cite data from the New York State Office of Mental Health showing substantial reductions in hospitalization, incarceration, homelessness, substance abuse, and suicide attempts following enrollment under Kendra's Law,........

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