自由剥夺的保障措施：我们准备好了吗？

Deprivation of liberty safeguards: how prepared are we?

机构信息

Betsi Cadwaladr University Local Health Board, North Wales and University of Wales Bangor, Wrexham Academic Unit, Technology Park, Croesnewydd Road, Wrexham LL11 7TY, UK.

出版信息

J Med Ethics. 2010 Mar;36(3):170-3. doi: 10.1136/jme.2009.032029.

DOI:10.1136/jme.2009.032029

PMID:20211998

Abstract

The Mental Health Act 2007 introduced Deprivation of Liberty safeguards into the Mental Capacity Act 2005 with potentially far reaching resource implications. There appears to be no scientific data regarding the prevalence of deprivation of liberty in clinical settings such as hospitals and nursing homes. We examined how many patients across a whole Trust area in Wales were subject to some lack of capacity, how well documented this was and how many were potentially deprived of their liberty. We found that no patient was deprived of their liberty, but 8% lacked capacity to make either basic or complex decisions; another 5% lacked capacity to make complex decisions. Documentation was good in mental health and community directorates, but there were gaps in documentation (not practice) in the medical and surgical directorates. Routine collection of data improved documentation regarding deprivation of liberty criteria. There is a high likelihood that senior nursing staff underestimate the number of patients who lack capacity.

摘要

2007 年《精神卫生法案》在 2005 年《精神能力法案》中引入了剥夺自由的保障措施，这可能会产生深远的资源影响。关于在医院和疗养院等临床环境中剥夺自由的普遍程度，似乎没有任何科学数据。我们调查了威尔士整个信托区有多少患者受到某种程度的能力丧失的影响，这些情况记录得如何，以及有多少人可能被剥夺了自由。我们发现没有患者被剥夺自由，但 8%的患者丧失了做出基本或复杂决策的能力；另有 5%的患者丧失了做出复杂决策的能力。在精神卫生和社区部门的文件记录良好，但医疗和外科部门的文件记录存在空白（而非实践）。常规收集数据可改善关于剥夺自由标准的文件记录。高级护理人员很可能低估了缺乏能力的患者人数。