社区强制权力的可接受性：心理健康服务使用者对监督出院和监护的伦理考量。
Acceptability of compulsory powers in the community: the ethical considerations of mental health service users on Supervised Discharge and Guardianship.
作者信息
Canvin K, Bartlett A, Pinfold V
机构信息
Department of Public Health, University of Liverpool, Brownlow Hill, Liverpool L69 3GB, UK.
出版信息
J Med Ethics. 2005 Aug;31(8):457-62. doi: 10.1136/jme.2003.004861.
OBJECTIVES
To explore mental health service users' views of existing and proposed compulsory powers.
DESIGN
A qualitative study employing in-depth interviews. Participants were asked to respond to hypothetical questions regarding the application of compulsory powers under the Mental Health Act 1983 for people other than themselves.
SETTING
Community setting in Southeast England.
PARTICIPANTS
Mental health service users subject to Supervised Discharge/Guardianship.
RESULTS
Participants considered that the use of compulsory powers was justified if there were some ultimate benefit, and if there was evidence of mental health problems, dangerousness, or a lack of insight. However, participants rejected intrusions into their autonomy and privacy.
CONCLUSIONS
This paper's participants indicated that the proposed CTO may be unacceptable because it would threaten service users' autonomy. Service users' acceptance of proposed changes is conditional and they emphasised the importance of consent; there is no suggestion that consent will be required for the CTO. The findings also have implications for the exploration of mental health service users' views and how they might contribute to policy, service planning, and research.
目标
探讨心理健康服务使用者对现有及拟议的强制权力的看法。
设计
采用深度访谈的定性研究。要求参与者回答关于根据1983年《精神健康法》对非自身人员适用强制权力的假设性问题。
背景
英格兰东南部的社区环境。
参与者
接受监督出院/监护的心理健康服务使用者。
结果
参与者认为，如果有某种最终益处，并且有心理健康问题、危险性或缺乏洞察力的证据，使用强制权力是合理的。然而，参与者拒绝侵犯他们的自主权和隐私。
结论
本文的参与者表示，拟议的社区治疗令可能不可接受，因为它会威胁服务使用者的自主权。服务使用者对拟议变更的接受是有条件的，他们强调同意的重要性；但对于社区治疗令，没有要求需征得同意的提议。这些发现也对探索心理健康服务使用者的观点以及他们如何为政策、服务规划和研究做出贡献具有启示意义。
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