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A Response To Savas's Comments On My
Simona GIORDANO*
* Ph.D., Centre for Social Ethics and Policy, The University of Manchester
According to a widespread belief, mental illness may impair autonomy and may lead people to behave in certain ways. On the basis of similar arguments, the diagnosis of mental illness is sometimes considered one of the criteria that justify paternalism. On my "In Defence of Autonomy in Psychiatric Health Care", I have argued that paternalism cannot even partly be based on grounds such as these. Savas has moved some objections to my arguments: psychiatric patients' autonomy is diminished by their dependence upon carers; I should have distinguished between psychoses and neuroses; mental illness may destroy people's decisionmaking capacity; people with mental illnesses cannot have the same right as anyone else to refuse psychiatric treatment. Here, I shall respond to Savas's objections. This will allow me to clarify some of my arguments and to strengthen my claim that the people with psychiatric diagnoses should be treated as anyone else.Keywords: Decision-making capacity, Autonomy in psychiatric health care, Right to refuse psychiatric treatment, Mental health care lawTurkiye Klinikleri J Med Ethics 2002, 10:178-185
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