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全球心理健康、自主性与医学家长主义:重构精神病学中的“法国伦理传统”

Global mental health, autonomy and medical paternalism: reconstructing the 'French ethical tradition' in psychiatry.

作者信息

Pires Marques Tiago

机构信息

Centre for Social Studies, University of Coimbra, Portugal.

出版信息

Hist Psychiatry. 2017 Sep;28(3):326-343. doi: 10.1177/0957154X17706475. Epub 2017 Apr 21.

Abstract

In the last few decades, the definition of deontological ethics, a well-identified ethical territory in psychiatry, has been the object of increasing concerns. This has been the case in France, where claims of a specific ethical tradition in psychiatry have accompanied the institutionalization of psychiatric ethics and the perceived globalization of an Anglo-American model of mental health care. This study traces the history of the 'French ethical tradition in psychiatry' and its relationship with establishing institutional spaces for ethical decision-making. The 'ethical tradition' thus conceived proves to be functional in terms of preserving the threatened identity of French psychiatry. Nevertheless, this movement also pinpoints impasses that transcend the French context and may provide valuable resources for ethical reflections on mental health on a global scale.

摘要

在过去几十年里,义务论伦理学(精神病学中一个已明确界定的伦理领域)的定义一直备受关注。法国就是如此,在那里,随着精神病学伦理学的制度化以及英美精神卫生保健模式的全球化,人们对精神病学中特定伦理传统提出了主张。本研究追溯了“法国精神病学伦理传统”的历史及其与建立伦理决策制度空间的关系。如此构想的“伦理传统”在维护法国精神病学受到威胁的身份方面被证明是有作用的。然而,这一运动也指出了超越法国背景的困境,可能为全球范围内关于精神卫生的伦理思考提供宝贵资源。

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