Dwangzorg

Dwangzorg, also called coercive or compulsory care, refers to situations in which care or treatment is provided to a person who cannot give informed consent, typically due to mental illness, cognitive impairment, or unsafe conditions. It is used only when it is judged necessary to prevent serious harm to the person or others or to provide essential treatment, and it is intended to be a last resort with strict safeguards and ongoing review.

In the Netherlands, the main legal frameworks are the Wet verplichte ggz (Wvggz) and the Wet zorg en dwang (Wzd). The Wvggz governs compulsory admission to and compulsory treatment within psychiatric care, establishing procedures to assess necessity, proportionality, and the possibility of appeal. The Wzd covers coercive measures in broader care settings, such as nursing homes and care for people with disabilities, detailing which measures may be imposed and under what oversight. Both laws emphasize the use of the least restrictive option, require thorough documentation, and protect the patient’s rights to information, complaints, and periodic review.

Implementation typically involves physicians and care teams determining that coercive care is necessary, there is imminent risk or deterioration without intervention, the patient lacks decision-making capacity, and no less intrusive alternative exists. Measures are usually time-limited and subject to regular evaluation, with some actions requiring court involvement or external oversight. Patients may have a representative, such as a mentor or curator, to safeguard their interests and participate in decision-making, and they retain rights to appeal.

Dwangzorg remains a topic of public debate, balancing individual autonomy with safety and access to care. Safeguards, transparency, and ongoing evaluation are central to reducing use and preventing abuse.