MacDonald Alastair J D, Roberts Alice, Carpenter Lain
Section of Old Age Psychiatry, Department of Psychological Medicine, Institute of Psychiatry, King's College, London.
Aging Clin Exp Res. 2004 Aug;16(4):326-30. doi: 10.1007/BF03324559.
There is growing interest in ethical issues in nursing home care, including capacity to consent to residence and covert medication use. This study assessed capacity to consent to residence amongst a group of randomly selected residents of non-specialist UK nursing homes and examined the prevalence of de facto imprisonment and covert medication.
A cross-sectional prevalence study amongst residents in randomly selected non-specialist nursing homes in South East England. 445 residents (97 men and 348 women) were randomly selected from 157 nursing homes.
14% (64) of the residents interviewed lacked the capacity to consent to residence. 6.1% (27) of residents were prevented from leaving but less than half of these lacked the mental capacity to consent to residence and may be therefore, de facto, unlawfully imprisoned. 4.7% (21) of residents on medication had received it covertly in the nursing home.
A significant number of residents in the nursing homes studied did not appear to have the mental capacity to consent to being there, possibly in contravention of the Human Rights Act 1998. There appears to be a small but worrying prevalence of de facto imprisonment, and covert medication use in residents without severe cognitive impairment.
养老院护理中的伦理问题，包括入住同意能力和秘密用药问题，正日益受到关注。本研究评估了英国非专科养老院中一组随机抽取的居民的入住同意能力，并调查了事实上的监禁和秘密用药的发生率。
在英格兰东南部随机抽取的非专科养老院居民中进行一项横断面患病率研究。从157家养老院中随机选取了445名居民（97名男性和348名女性）。
接受访谈的居民中有14%（64人）缺乏入住同意能力。6.1%（27人）的居民被阻止离开，但其中不到一半的人缺乏入住同意的心智能力，因此可能在事实上被非法监禁。在服用药物的居民中，有4.7%（21人）在养老院中接受了秘密用药。
在所研究的养老院中，相当数量的居民似乎没有心智能力同意入住，这可能违反了1998年《人权法案》。事实上的监禁现象虽少但令人担忧，而且在没有严重认知障碍的居民中存在秘密用药的情况。
