Widdershoven Guy, Berghmans Ron
Maastricht University, Department of Health, Ethics and Society/Metamedica, Research School Caphri, The Netherlands.
J Med Ethics. 2007 Oct;33(10):560-3. doi: 10.1136/jme.2005.015545.
Coercion and pressure in mental healthcare raise moral questions. This article focuses on moral questions raised by the everyday practice of pressure and coercion in the care for the mentally ill. In view of an example from literature-the story of Ulysses and the Sirens-several ethical issues surrounding this practice of care are discussed. Care giver and patient should be able to express feelings such as frustration, fear and powerlessness, and attention must be paid to those feelings. In order to be able to evaluate the intervention, one has to be aware of the variety of goals the intervention can aim at. One also has to be aware of the variety of methods of intervention, each with its own benefits and drawbacks. Finally, an intervention requires a context of care and responsibility, along with good communication and fair treatment before, during and after the use of coercion and pressure.
精神卫生保健中的强制和压力引发了道德问题。本文关注的是在精神病护理中日常施加压力和强制行为所引发的道德问题。鉴于文学作品中的一个例子——尤利西斯与塞壬的故事，探讨了围绕这种护理行为的几个伦理问题。护理人员和患者应该能够表达诸如沮丧、恐惧和无助等情绪，并且必须关注这些情绪。为了能够评估干预措施，人们必须意识到干预措施可能针对的各种目标。人们还必须意识到干预方法的多样性，每种方法都有其自身的优缺点。最后，一项干预措施需要有护理和责任的背景，以及在使用强制和压力之前、期间和之后的良好沟通和公平对待。
