Researchers at the Department of Law receive millions from the Swedish Research Council for research projects on decision-making capacity and compulsory care

What is the role of patients' decision-making capacity when coercion is used in health care? This and other questions will be answered in a research project recently funded by the Swedish Research Council. Photo: Unsplash
The Swedish Research Council grants SEK 4.9 million to the project "Decision-making capacity and coercive care - law, ethics and the management of non-consenting patients in psychiatric and somatic care".
Moa Dahlin, associate professor and senior lecturer in public law, is leading the project.

Moa Dahlin, leader of the project and Therése Fridström Montoya, Niklas Juth and Stefan Sjöström. Photo: Unknown, Mikael Walletstedt, Mikael Walletstedt, Private
Can it be justified to force individuals to receive care to which they have not consented? Legal and ethical literature highlights (lack of) decision-making capacity as a key concept to legitimise coercion in health care. However, decision-making capacity is a difficult concept to define and also difficult to assess in individual patients. In Sweden, lack of decision-making capacity is not a prerequisite for compulsory care and the compulsory care legislation applies exclusively to persons with a ‘severe mental disorder’. However, coercion is known to occur in other areas of healthcare as well, for example in the care of patients with dementia. The legal support for such interventions is questionable, but in some cases is considered ethically justified.
The aim of the research project is to investigate the role of patients' decision-making capacity when coercion is used in health care. The research is conducted using legal and ethical analysis methods, but also empirical studies of the clinical practice of patients who do not consent to care. Interviews and observations are conducted in psychiatry, dementia care and diabetes care, the latter as a contrast to the other forms of care where patients' illness can affect decision-making capacity. In parallel with the sub-studies, a joint interdisciplinary analysis is underway, aiming to combine the different disciplinary perspectives.
This project highlights general issues and patterns in the regulation and use of coercion in health care. The aim is a constructive multidisciplinary discussion on how to achieve a more coherent and robust management of patients who lack decision-making capacity.
Facts about the research project
Grant provider: The Swedish Research Council
Amount granted: 4 902 000 SEK
Time period for the project: 2025-2027
Participating researchers at Uppsala University:
Moa Dahlin, Principal Investigator (PI), associate professor and senior lecturer in public law, Department of Law
Therése Fridström Montoya, Associate Professor and Senior Lecturer of Private Law, Department of Law
Niklas Juth, Professor of Bioethics at the Department of Public Health and Care Sciences and Centre for Research & Bioethics
Stefan Sjöström, Professor of Social Work at the Department of Social Work