The psychiatrist as gaoler

Abstract Psychiatrists have a number of ‘gaoler roles’: that is, they are involved in the detention and compulsory treatment of patients for the protection of others rather than for the good of the patient. Psychiatrists often feel uneasy about these roles, and may even deny that they exercise them. In principle—an argument based on human rights theory—it can be justifiable for the state to ‘gaol’ in appropriate cases. One line of argument contends that, none the less, this should not be the job of doctors. This argument is rejected in principle. Moreover, in practice psychiatrists will inevitably take other people's interests into account whether consciously or not, and political reality dictates that psychiatrists cannot escape their gaoler function.