Pollmächer T
Zentrum für psychische Gesundheit, Klinikum Ingolstadt, Krumenauerstr. 25, 85049, Ingolstadt, Deutschland,
Nervenarzt. 2015 Sep;86(9):1148-56. doi: 10.1007/s00115-015-4303-z.
The current intensive discussion on the legal and moral aspects of involuntary treatment of psychiatric patients raises a number of ethical issues. Physicians are unambiguously obligated to protect patient welfare and autonomy; however, in psychiatric patients disease-related restrictions in the capacity of self-determination and behaviors endangering the rights of third parties can seriously challenge this unambiguity. Therefore, psychiatry is assumed to have a double function and is also obligated to third parties and to society in general. Acceptance of such a kind of double obligation carries the risk of double moral standards, placing the psychiatrist ethically outside the community of physicians and questioning the unrestricted obligation towards the patient. The present article formulates a moral position, which places the psychiatrist, like all other physicians, exclusively on the side of the patient in terms of professional ethics and discusses the practical problems arising from this moral position.
当前对精神病患者非自愿治疗的法律和道德层面的激烈讨论引发了一些伦理问题。医生明确有义务保护患者的福利和自主权；然而，对于精神病患者，与疾病相关的自我决定能力限制以及危及第三方权利的行为会严重挑战这种明确性。因此，精神病学被认为具有双重功能，并且对第三方乃至整个社会也负有义务。接受这种双重义务存在双重道德标准的风险，使精神科医生在伦理上置身于医生群体之外，并对其对患者的无限制义务提出质疑。本文阐述了一种道德立场，即在职业道德方面，精神科医生与所有其他医生一样，完全站在患者一边，并讨论了这一道德立场引发的实际问题。
