Source: (2010) International Journal of Mental Health Nursing. 19(3): 151-153.

John Rawles (2004, p. 230) famously asserted that ‘Justice is the first virtue of social institutions, as truth is of systems of thought’. Truth and justice, he argued, are not to be compromised, and laws and institutions must be abolished or reformed if found to be unjust. Nevertheless, justice tends not to be the first principle of appeal or consideration in ethical deliberations in mental health care. For example, breaching people’s autonomy through involuntary or coercive treatment, or containment through the use of practices, such as seclusion (reviewed by Happell in this edition), are common but profoundly ethical problems within mental health services. Such practices are typically justified with reference to the principle of beneficence, that they are in the person’s best interests, and/or non-intervention would lead to harm to the individual or others. Justice does not typically enter the equation, except in the sense of ‘procedural justice’, that is, ensuring that people are seen to be dealt with fairly by having access to second opinions, timely reviews, and otherwise competent treatment. There are, however, other important conceptions of justice that are at least as relevant to mental health service provision. (Excerpt).