Data regarding 150 cases of involuntary hospitalization at a psychiatric emergency clinic and psychiatric hospitals were examined. Although the criteria for involuntary hospitalization were set by the Health and Welfare Ministerial Order, cases in which designated physicians of mental health felt it difficult to make a clinical diagnosis and/or to evaluate in terms of "likely to hurt oneself or others" were encountered. In these cases, physicians may be obliged to make a medical statement based on "pretext". The author herein discusses the drawbacks of the present examination system and suggests several options for reform.
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