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Table 5 Inducement

From: Persuasion or coercion? An empirical ethics analysis about the use of influence strategies in mental health community care

Theme 3 Inducement

Perception

Subtheme

Excerpt

Quotes

Non coercion

Positive reinforcement

E.16

(EN103, psychiatrist) The last two blur into each other a little bit, because inducement and threat, like “if you do this, then you can have left, if you don’t do this then we’re gonna take your leave away”, whether that’s an inducement or that’s a threat like it’s a bit like positive reinforcement versus negative reinforcement, but there’s a sliding scale there, I think

Negotiation

E.17

(SP102, psychologist) in the inducement a professional try to convince the patient to take the medication without to use the force, but at the same time trying to negotiate with him, “look, if you accept the treatment you will get this one, or you won’t lose that one (and I give this one)

Therapeutic agreement

E.18

(MX212, psychologist) I would be inclined to the induction in order to improve the patient awareness about his/her circumstances, and with this, would explore any family support in order to assure patient’s compliance […] generally I start with induction in order to inform the patient about his/her circumstances, who will support the patient, which resources will be available to the patient and doctor and see what will manage the therapeutic strategy

Coercion

Enticement

E.19

(SW105, nurse) Cigarettes were mentioned too. Something we can entice them with. Many have cigarettes and they have a cigarette allowance. This is something that we regulate so it’s a question of when they get them or when they don't get them. They have cigarettes that we set aside for them.”If you take your medicine, I'll go and get you a cigarette.” That's how it is

Coercion

E.20

(IT317, psychiatrist) perhaps for induction and threat yes (he refers to the definition of coercion), I mean […] you are thinking about you are doing in their best interests. However, I feel induction and threat as coercion

Manipulation

E.21

(CA1 Facilitator) They call it an inducement, or an incentive—(CA101, psychiatrist) I’d call a manipulation, and it’s unwise. And I would object to the last section (it refers to the case vignette 1), where it said, ‘It appears there may be some other agency or institution involved regarding seeing your children.’ So, one would want to know what that is to what you can call anything around access to the children’ coercion’ or again safety, concerning the law

Harm doctor-patient relationship

E.22

(CH309, nurse) I do not agree to use the induction because it can affect the boundary between doctor and patient in the sense that patient is generally demanding. If a patient accedes to the treatment in a change of something, the treatment can fail because the patient will be excessively demanding

Extortion in the patient’s best interests

E.23

(CR301, psychiatrist) (referring to inducement) You call it offering rewards, and I suppose that’s what it could be called […] Now, whether that’s a threat, a reward or extortion… It’s good either way