Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Ulm, Germany.
Int Rev Psychiatry. 2010;22(3):258-66. doi: 10.3109/09540261.2010.485979.
In the treatment of children with psychiatric disorders as a vulnerable population, ethical issues arise that seldom come into play with adults. The UN Conventions on the Rights of the Child and the Rights of Persons with Disabilities set out rights to be respected in child and adolescent psychiatric treatment. Rights of participation and inclusion (minimizing of barriers to the involvement of disabled people) can create complex problems in cases of restraint or deprivation of liberty. This paper analyses the consequences of these conventions and other ethics guidelines on child and adolescent psychiatric treatment and research. Beneficence, justice and autonomy are core principles that are mirrored in the problems of inclusion and protection, confidentiality, and the safety of psychopharmacological interventions. Factors of inclusion are involved in the areas of availability of care, participation in best evidence-based treatment, and research. The right of the child to protection, the right of inclusion, and parents' rights and duties to safeguard their child's wellbeing form a triangle. National laws to regulate the treatment of psychiatrically ill children should be created and implemented and these should be non-discriminatory but at the same time safeguard the developing human being.
在治疗儿童精神障碍时,儿童作为弱势群体,会出现一些在治疗成人时很少出现的伦理问题。《联合国儿童权利公约》和《残疾人权利公约》规定了在儿童和青少年精神科治疗中应尊重的权利。参与和包容的权利(尽量减少残疾人参与的障碍)可能会在限制或剥夺自由的情况下造成复杂的问题。本文分析了这些公约和其他伦理准则对儿童和青少年精神科治疗和研究的影响。善行、公正和自主是包容和保护、保密以及精神药物干预安全性这些问题的核心原则。包容的因素涉及到护理的可及性、参与最佳循证治疗以及研究。儿童的保护权、包容权以及父母保护孩子福祉的权利和义务构成了一个三角形。应该制定和实施规范治疗精神疾病儿童的国家法律,这些法律应该是无歧视的,但同时也要保护正在发育的人类。