It is extremely unlikely that an individual will give up a bad behavior if they do not feel any need to do so. Even if it is possible to physically prevent that person from engaging in the act they will still likely resume it as soon as they get the chance. This is why for real change to occur the person has to be a willing participant. When they have summoned the will to do something it will give them needed motivation, and they can then go on to accomplish some amazing things. This same logic applies to addiction recovery. In order for the individual to escape their downward spiral they need to be willing and give informed consent for any treatment on offer.
Informed consent most usually refers to a process whereby an individual consents to a proposed treatment or procedure because they understand that it would benefit them to do so. It is most often used in relation to medical treatments. A more precise definition might say that informed consent is a legal procedure to ensure that a patient, client, and research participants are aware of all the potential risks and costs involved in a treatment or procedure.
The Dutch philosopher Baruch Spinoaz is reported to have said that:
He alone is free who lives with free consent under the entire guidance of reason.
If a stranger walked up to a person in the middle of a street and stuck a needle in them it would be viewed as an assault. Yet in hospitals it is permissible for surgeons to cut open a human’s body and even remove their organs. The reason for why medical professionals are not regularly charged with assault is the understanding that their actions are benevolent, and the individual they are treating will have given their consent.
Informed consent is an ethical principle that philosophers have debated for thousands of years. It became of greater concern in the last century after the horrific actions of the Nazis. Along with murdering millions of people they also carried out experiments on them –some of these procedures involved a great deal of pain and suffering. After the war there were demands that such atrocities should never happen again, and this led to the Nuremberg Code which greatly increased the significance of informed consent in public life. The civil rights movement of the 1960s further pushed informed consent higher up on the agenda. This led to a toughening up of regulations in regards to people been subject to any type of medical treatment against their will.
In order for consent to be considered informed it needs to contain certain elements including:
* It is vital that the person has a reasonable understanding of what is being proposed. If they do not comprehend what they are agreeing to then their consent cannot be said to be informed.
* The individual should be assessed to determine their ability to comprehend the information being provided. It is not reasonable to just offer this person information that they can’t possibly be expected to understand – any information will need to be adjusted to suit their comprehension level.
* After the information has been provided there should be a further assessment to determine that they have actually understood what is being said.
* The individual needs to be told about reasonable alternatives to any proposed treatments. This is so they can make their own mind up about what is best for them.
* The person willingly agrees to the proposed procedure with no need to coerce them.
If people who were undergoing treatment in hospital had to give informed consent for everything that was done to them it would bring the system to a standstill. It could even mean that surgeons would have to wake their patients up in the middle of an operation to notify them of any changes to the plan. In order to keep things working smoothly, the notion of implied consent is used. This type of consent can be defined as not expressly granted by a person, but rather inferred from a person’s actions and the facts and circumstances of a particular situation. A good example of implied consent occurs when a nurse takes a patient’s blood pressure. The fact that this person offers their arms means that they have given implied consent. In this situation the nurse would not be expected to explain the procedure and why it is required – although if they had time it would be good for them to do so.
Up until the 1970s it was quite common for addicts to be committed to treatment facilities against their will. This changed due to growing concerns about civil liberties. There was outrage when the media began reporting stories of people being kept locked up for years on the basis of information provided by their family members. It is now far more difficult to arrange involuntary commitment for addiction treatment, but it can happen if it is believed that the individual is an imminent danger to themselves or other people.
It is generally agreed that informed consent is important for addiction treatment because:
* There is a wise saying that states, you can bring a horse to water but you can’t make it drink. If the individual does not agree to the treatment they can refuse to take part in any activities.
* In order to get the most from time spent in rehab the individual has to be fully willing to make the best use of the available resources. There is a great deal to learn and the individual has to take responsibility for getting the most out of the program.
* The individual will often be full of anger and resentment about being put somewhere against their will. It might not only guarantee failure in the current recovery attempt, but it could put them off making any further attempts in the future.
* It may be possible to prevent the person from drinking or using drugs while they are in rehab but as soon as they go home they will have not motivation to stay clean and sober.
* In order for people to get the most out of recovery they have to own it. It is their future and they need to take charge so they will be going in a direction that they desire.
* This type of action may permanently destroy any trust between the individual and their family. It can also destroy their trust in the medical profession.
* Addiction professionals will have ethical concerns about dealing with any individual who has not given their consent for treatment. It will also make their job that much harder.
* It was once too easy to have somebody committed to treatment against their will. There were many instances where it occurred unfairly.