Case Study on Aggression and Ethical Considerations in Mental Health

Running head: CASE STUDY
Case Study
Name of the Student
Name of the University
Author Note

1CASE STUDY
Introduction- Aggression is commonly referred to as harmful social interaction that a
person has with people surrounding him/her, with the intention of causing unpleasant behaviour
or inflicting harm or damage (Moore et al. 2014). Human aggression is typically categorised into
indirect and direct forms. While the former is characterized by intended harmful behaviour that
creates an impact on social relation, the latter is characterized by verbal or physical behaviour
that harms others (Hoeve et al. 2015). This essay will elaborate on a case study where a person
manifesting aggression towards healthcare workers had been admitted to the service. It will also
illustrate the ethical considerations that should be taken into account under such circumstances
and strategies for conflict resolution and assertiveness.
Case study- John had been admitted to the mental health service at the request of his
spouse who complained that he recently started manifesting signs of being aloof and emotionally
absent. His presenting complaints were social isolation and the lack of interest in family life. He
considered his wife’s complaints to be unreasonable and demonstrated a negativistic attitude
towards completion of routine occupational and social task. He complained of being
unappreciated and misunderstood, was argumentative, and demonstrated poor self confidence. In
addition, some other common symptoms were associated with procrastination, stubbornness,
deliberate inefficiency, intentional failure at tasks and pretended forgetfulness.
He had been diagnosed with bipolar disorder five years back, following which he was
forcefully subjected to psychotherapy. This made him display aggression towards healthcare
workers as he considered psychotherapy as a major form of con-artistry. His mother suffered
from severe mood disorder. In addition, John has been addicted to alcohol and drugs since his
teenage years that often made his mood episodes become worse. On further investigation it was
also found that he suffered a trauma due to relocation of his family from their ancestral village to

2CASE STUDY
the city, following which she had also been subjected to neglect from his parents. Hence, the
aforementioned factors might have increased the likelihood of displaying aggression and resulted
in the onset of passive aggressive personality disorder.
Ethical considerations- The four core principles related to biomedical ethics encompass
beneficence, autonomy, justice, and non-maleficence. There is mounting evidence for the fact
that passive aggressive personality disorder can be effectively treated through the
implementation of psychodynamic methods, the primary objective of which relies on revealing
unconscious content of the psyche, for alleviating psychic tension. However, taking into
consideration the resentment of the patients towards healthcare workers and the misconceptions
that he holds about psychotherapy, there is a probability of conflict. The primary step would be
to intervene even if the patient disagrees, followed by implementation of psychotherapy in order
to maximize health outcomes (Hoagwood, Jensen and Fisher 2014). The autonomy of the patient
must be respected since he has a decision making capacity. Consent must be taken from his
family members as well, prior to the intervention implementation. Therapeutic association with
John must also be grounded on feelings of mutual trust, and there should be a responsibility of
informing him and his family members about the nature of his mental health, expected outcomes,
risks, and benefits of the treatment alternative. Treatment recommendations will also be based on
best professional judgment and John will be delivered services with respect and altitude,
notwithstanding the setting. While involuntary hospitalization or treatment is ethically
controversial, treatment decision without John’s consent can be ethically justified because he
suffers from a severe mental illness, which holds the likelihood of harming self or others (Fazel
et al. 2014). Privacy and confidentiality of the patient will also be protected during the care
regimen.