Abstract
One response to the problems created by deinstitutionalization has been outpatient commitment. Involuntary community treatment presents a series of dilemmas, including those involving the role of enforced treatment in psychiatry, the implementation of informed consent, the application of “least restrictive alternative,” and the ever-widening liability of psychiatrists. While outpatient commitment itself presents conundrums, outpatient commitment which is unenforceable brings the psychiatrist to even further quandaries. Using Pennsylvania as an example, the difficulties posed by unenforceable outpatient commitment are presented. The author concludes that although coerced community treatment may be successful even without legal sanctions, this is not an ethically sound solution.
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