Meise Ullrich, Frajo-Apor Beatrice, Stippler Stippler, Wancata Johannes
Gesellschaft für Psychische Gesundheit - pro mente tirol, Innsbruck.
Neuropsychiatr. 2011;25(1):44-50.
History shows that the discussion concerning coercive measures against mentally ill is as old as psychiatry itself. The dilemma of psychiatry lies in its double role - having both a therapeutic and a regulatory function. Violence against sick and disabled people conflicts with the ethical principles of helping professions. This, however, is where the danger lies: that the violent parts of psychiatric work - which in the opinion of experts cannot be entirely avoided - are repressed or seen as taboo and are therefore more difficult to control. Comparisons between EU countries of the nature, frequency and duration of coercive measures are difficult because of the heterogeneity of regulation and differences in established practice. Scientific examination of this issue seems to be insufficient. There are only a few studies on important issues such as how patients rate these measures. An open and thorough debate about the meaning and meaninglessness of coercion and violence in psychiatric treatment would be necessary to prevent "routine violence" or the excessive use of force against the mentally ill.
历史表明，有关针对精神疾病患者的强制手段的讨论与精神病学本身一样古老。精神病学的困境在于其双重角色——兼具治疗和监管功能。针对患者和残疾人的暴力行为与助人职业的伦理原则相冲突。然而，危险就在于此：精神病工作中存在暴力部分——专家认为这无法完全避免——却被压抑或视为禁忌，因此更难控制。由于监管的异质性和既定做法的差异，很难对欧盟国家强制手段的性质、频率和持续时间进行比较。对这个问题的科学研究似乎并不充分。关于患者如何评价这些措施等重要问题的研究仅有少数。为防止“常规暴力”或对精神疾病患者过度使用武力，有必要就精神病治疗中强制和暴力的意义与无意义展开公开而深入的辩论。
