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[精神病学中的强制治疗:对临床实践新法律法规的伦理分析]

[Compulsory treatment in psychiatry: an ethical analysis of the new legal regulations for clinical practice].

作者信息

Vollmann J

机构信息

Institut für Medizinische Ethik und Geschichte der Medizin, Ruhr-Universität Bochum, Markstr. 258a, 44799, Bochum, Deutschland,

出版信息

Nervenarzt. 2014 May;85(5):614-20. doi: 10.1007/s00115-013-3866-9.

Abstract

BACKGROUND

The new legal regulations of compulsory treatment in Germany require a change in clinical psychiatric practice as well as an ethical analysis of the consequences for those involved.

MATERIALS AND METHODS

The new legal regulations are reported and via ethical analysis new problematic fields, such as consequences of the new law are identified and discussed in the context of psychiatry and law.

RESULTS

The main ethical identified problems are care of mentally ill with mental competence who refuse medical treatment, the different normative assessment of compulsory treatment and mechanical fixation, the ambivalent role of the conversation between psychiatrist and patient in order to change the natural will of the patient to avoid compulsory measures, the ethical consequences of questionable financial incentives in the context of compulsory treatment and the contradictive legal regulations in the field.

CONCLUSIONS

The ethical analysis of the new law on compulsory treatment in Germany shows chances for improvement of clinical psychiatric practice as well as normative problematic regulations and fields of conflicts.

摘要

背景

德国新的强制治疗法律规定要求临床精神病学实践做出改变,并对相关人员的后果进行伦理分析。

材料与方法

报告新的法律规定,并通过伦理分析确定新的问题领域,如在精神病学和法律背景下讨论新法律的后果。

结果

确定的主要伦理问题包括对有精神行为能力但拒绝治疗的精神病患者的护理、对强制治疗和机械约束的不同规范性评估、精神科医生与患者谈话以改变患者自然意愿以避免强制措施的矛盾角色、强制治疗背景下可疑经济激励措施的伦理后果以及该领域相互矛盾的法律法规。

结论

对德国强制治疗新法律的伦理分析显示了改善临床精神病学实践以及规范有问题的法规和冲突领域的机会。

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