What is the role of procedural justice in civil commitment?

Objective: To determine best practice management strategies in the clinical application of civil commitment. Method: All relevant literature on the topics of 'civil commitment', 'coerc ion' and 'procedural justice' were located on MEDLINE and PsychLIT database s and reviewed. Literature on the use of Ulysses contracts and advance dire ctives in mental health treatment was integrated into the findings. Results: Best practice evidence that guides management strategies is limite d to the time of enactment of civil commitment. Management strategies invol ve enhancing the principles of procedural justice as a means of limiting ne gative patient perception of commitment. In the absence of evidence-based r esearch beyond this point of enactment, grounds for the application of the principles of procedural justice are supported by reference to ethical cons iderations. Ulysses contracts provide an additional method for strengthenin g procedural justice. Conclusions: Procedural justice principles should be routinely applied thro ughout the processes of civil commitment in order to enhance longer term th erapeutic outcomes and to blunt paternalism.