ABSTRACT
Introduction Apart from preemptive detention in the case of national security in the post-9/11 world, only psychiatrists have the distinct power of both restricting the liberty of citizens and enforcing medical treatment. This is the most dramatic manifestation of the relationship between the psychiatric profession and the community. Prior to the nineteenth century, involuntary psychiatric commitment was an arbitrary process enacted by physicians, often in collusion with families. The mentally ill of that era were the object of fear and ridicule; in the eighteenth and nineteenth centuries, one could pay to visit (and taunt) the inmates of Bedlam hospital, rather like animals in the zoo. The use and abuse of this unique form of power underlies many of the distinct ethical dilemmas faced by psychiatrists. It is evident that with the endowment of such power, societal expectations of the psychiatric profession are immense, in aspects of both public safety and patient welfare.
