Tam Christopher, Law Samuel
Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada.
Psychiatr Serv. 2007 Apr;58(4):457-9. doi: 10.1176/ps.2007.58.4.457.
A significant proportion of patients of assertive community treatment (ACT) teams will adamantly refuse medication. Whether the team should continue to encourage medication or put a hold on advocating for medication is a clinical and ethical dilemma. On the basis of their clinical experiences, the authors propose best-practices criteria that ACT teams can consider in deciding whether medications may be temporarily discontinued when a patient refuses them. The authors suggest that in some circumstances stopping medications in such a case may help in the development or repair of a therapeutic alliance over the long term.
积极社区治疗（ACT）团队中有相当一部分患者会坚决拒绝服药。团队是应继续鼓励服药还是暂停主张服药，这是一个临床和伦理困境。基于他们的临床经验，作者提出了一些最佳实践标准，ACT团队在决定患者拒绝服药时是否可暂时停药时可以考虑这些标准。作者建议，在某些情况下，这种情况下停药可能有助于长期建立或修复治疗联盟。
