Harding T W
Institute of Forensic Medicine, University of Geneva, Switzerland.
Acta Psychiatr Scand Suppl. 2000;399:24-30. doi: 10.1111/j.0902-4441.2000.007s020[dash]6.x.
The 'centrepiece' of international human rights law in the field of mental health is often said to be the United Nations Principles for the Protection of Persons with Mental Illness of 1991. Some observers appreciate the symbolic importance of these principles in providing visibility to the needs of the mentally ill, in stressing the right of access to adequate mental health care and in establishing the principle equivalence between psychiatry and the rest of medicine. However, the Principles appear basically flawed in several respects: (1) they do no have the status of a formal international treaty; (2) States are not required to adopt the Principles as 'minimum standards' for the protection of mentally ill persons; (3) in some respects, notably on the issue of consent to treatment, the Principles remove patients' rights rather than reinforce them; (4) the Principles do not provide for redress nor for any form of monitoring, inspection or supervision by an independent international body. Thus, it appears that even at an international level the deep-seated societal ambivalence towards the mentally ill has taken root and that so called 'human rights' principles have little material effect on the lives of psychiatric patients and create double standards in the exercise of choice.
国际人权法在精神卫生领域的“核心内容”常被认为是1991年联合国《保护精神疾病患者原则》。一些观察家赞赏这些原则在使精神疾病患者的需求受到关注、强调获得适当精神卫生保健的权利以及确立精神病学与其他医学领域同等地位方面的象征意义。然而，这些原则在几个方面似乎存在根本缺陷：（1）它们不具有正式国际条约的地位；（2）各国无需将这些原则作为保护精神疾病患者的“最低标准”予以采纳；（3）在某些方面，尤其是在治疗同意问题上，这些原则削弱而非加强了患者的权利；（4）这些原则未规定补救措施，也未规定由独立国际机构进行任何形式的监测、检查或监督。因此，即使在国际层面，社会对精神疾病患者根深蒂固的矛盾态度似乎也已根深蒂固，所谓的“人权”原则对精神病患者的生活几乎没有实际影响，并且在选择的行使方面造成了双重标准。
