On the legitimacy of medical actions which benefit a third party, especially in psychiatry

Justification of medical acts relies primarily on the patient's beneficence and consent; however, interests of third parties can also contribute to legitimation. The present paper investigates under which circumstances this may or may not be the case. It turns out that medical acts are particularly problematic if they are justified exclusively by the interests of third parties. Prominent examples are abortion as well as under certain circumstances, detention and coercion of psychiatric patients in psychiatric and forensic hospitals. The latter are particularly problematic if they occur without treatment possibilities. Treatment of patients in detention may be impossible because it contradicts the will and preferences of the patient or just because no effective treatment is available. In such situations it seems morally and professionally questionable whether physicians may engage in and be responsible for coercive measures which are exclusively aimed at protecting third parties; however, biomedical ethics so far have rarely addressed these issues indicating a need for further research.