Lehmann Peter
Epidemiol Psichiatr Soc. 2005 Jan-Mar;14(1):15-21. doi: 10.1017/s1121189x00001883.
In this article the author--board-member of the European Network of (ex-) Users and Survivors of Psychiatry (ENUSP)--explains, what is needed to guarantee a minimal level of involvement of users and survivors of psychiatry into issues relating to psychiatric drugs.
He reflects demands of their organisations, and compares these demands with the current involvement level. Considering the concrete circumstances in psychiatry, he reflects the risks and dangers of the administered drugs--especially the widely used neuroleptics--for example enhanced breast cancer risk in women, suicidal effects, receptor changes, tardive dyskinesia and other toxic reactions.
Considering the unique situation of psychiatric patients to receive treatment in general without informed consent and in a violent way or through bullying and threat, he argues for to provide their involvement in all aspects of psychiatric drug issues--especially registration and monitoring, for example by their involvement in creating and running a suicide register. And he argues for involvement in ethics committees, licensing processes and providing guidelines and decision making about effectiveness and reimbursement of costs.
As first steps towards these aims he proposes independent and user-controlled research, independent and user-controlled education and independent and user-controlled information about the effects of psychiatric drugs.
在本文中,作者——欧洲精神病学(前)使用者及幸存者网络(ENUSP)的董事会成员——解释了要确保精神病学的使用者和幸存者在与精神科药物相关问题上达到最低参与程度需要哪些条件。
他思考了这些组织的要求,并将这些要求与当前的参与程度进行比较。考虑到精神病学的具体情况,他思考了所使用药物——尤其是广泛使用的抗精神病药物——的风险和危险,例如女性患乳腺癌风险增加、自杀效应、受体变化、迟发性运动障碍及其他毒性反应。
考虑到精神病患者通常在未获得知情同意的情况下以暴力方式或通过欺凌和威胁接受治疗的独特情况,他主张让他们参与精神科药物问题的各个方面——尤其是注册和监测,例如通过让他们参与创建和管理自杀登记册。他还主张让他们参与伦理委员会、许可程序,并就药物疗效和费用报销提供指导方针及决策。
作为实现这些目标的第一步,他提议开展独立且由使用者控制的研究、独立且由使用者控制的教育以及关于精神科药物效果的独立且由使用者控制的信息传播。