Weinstein Henry C
New York University Medical Center and Bellevue Hospital Center, 550 First Avenue, New York, NY 10016, USA.
Behav Sci Law. 2002;20(5):443-61. doi: 10.1002/bsl.504.
The term 'security hospital' is used for a variety of facilities including forensic hospitals and prison hospitals, which, because of their mission, the nature of their work, and the populations they serve-or because of the authority under which they operate-place the staff at considerable risk of ethical violations related to either clinical care or to forensic activities. The problem of divided loyalties is of special concern in security hospitals. Ethics principles particularly at risk are confidentiality and informed consent. Where there are cultural disparities between the staff and the patients, differences in background, socioeconomic class, education, and other types of diversity, cultural awareness is required and must be reflected in appropriate treatment and evaluation. To counteract the risks of ethical violations, a security hospital should create an ethical climate and develop means to anticipate, prevent, and deal with ethical violations. These might include detailed and specific policies and procedures, programs of orientation, education, consultation, and liaison as well as its own ethics committee.
“安全医院”一词用于多种设施，包括法医医院和监狱医院。由于其使命、工作性质、所服务的人群，或者由于其运营所依据的权力，这些医院的工作人员面临着与临床护理或法医活动相关的严重违反伦理道德的风险。在安全医院中，忠诚冲突问题尤其令人担忧。特别容易受到风险影响的伦理原则是保密和知情同意。当工作人员与患者之间存在文化差异、背景、社会经济阶层、教育程度及其他类型的多样性差异时，就需要具备文化意识，并且必须在适当的治疗和评估中体现出来。为了应对违反伦理道德的风险，安全医院应营造一种伦理氛围，并制定方法来预测、预防和处理违反伦理道德的行为。这些方法可能包括详细具体的政策和程序、入职培训计划、教育、咨询和联络项目，以及医院自己的伦理委员会。
