1. About the project


    In many jurisdictions, persons with mental disorders can be admitted to hospital and treated against their will in situations where they pose a risk to themselves or others. These justifications are often taken for granted.

    Mindful of Salus, the Roman goddess of well-being and security, the Bochum SALUS project will explore the nature and normative force of service user well-being and the security of third parties in the context of coercive interventions.


    The Bochum SALUS project aims to determine under which conditions (if any) considerations of well-being and security can justify coercive interventions and to prevent potential conflicts between autonomy, well-being and security by integrating explicit consideration of the latter two values into the advance care planning process. In the course of the project, we will

    1. identify implications of recent autonomy-enhancing policy measures for the well-being of service users and the security of third parties;
    2. examine the attitudes of mental health professionals, service users and the general public toward coercive interventions in psychiatry;
    3. determine under which conditions, if any, involuntary interventions are morally justifiable;
    4. improve the quality of psychiatric advance directives by integrating an explicit consideration of issues surrounding well-being and security into the advance care planning process; and
    5. assess and evaluate the opportunities and challenges of self-binding directives and explore possibilities for implementation in Germany.


    The SALUS project takes an innovative bottom-up approach in which conceptual and normative analyses are informed by, and closely interlinked with, qualitative and quantitative empirical research. The method at a project-level is reflective equilibrium. This method consists in a deliberative process of working up and down from considered judgments about specific cases to moral principles governing these cases.

    The project derives fundamental moral principles from legal documents and stakeholders’ attitudes and investigates considered judgments about individual cases by adopting an empirical bioethics approach. Empirical bioethics consists of the systematic study of stakeholders’ moral beliefs about bioethical issues by means of methods of the social sciences. The empirical bioethics branch will be operationalized using a mixed-method approach of qualitative and quantitative methods.


    The questions of the SALUS project will be addressed in four workstreams, each encompassing various empirical, ethical and conceptual studies:

    I. Well-being, security and coercion in general psychiatry

    II. Ethical challenges in forensic psychiatry

    III. Improving the advance care planning process

    IV. Opportunities and challenges of self-binding directives

    Project structure

    SALUS is funded by the German Ministry for Education and Research (BMBF) as an independent research group in the field of ethical, legal and social aspects of modern life sciences. The research group builds a bridge between the Institute for Medical Ethics and History of Medicine of the Ruhr University Bochum and the Department of Psychiatry, Psychotherapy and Preventive Medicine at the LWL University Hospital of the Ruhr University Bochum.

    We are supported by national and international collaboration partners and advisory board members who are all leading experts in their field.