Stenlund Mari
Department of Systematic Theology, University of Helsinki, P.O.Box 4, 00014 University of Helsinki, Finland.
J Med Ethics. 2017 Aug 9. doi: 10.1136/medethics-2016-103637.
This article clarifies how the freedom of thought as a human right can be understood and promoted as a right of mental health service users, especially people with psychotic disorder, by using Martha Nussbaum's capabilities approach and Fulford's and Fulford 's values-based practice. According to Nussbaum, freedom of thought seems to primarily protect the capability to think, believe and feel. This capability can be promoted in the context of mental health services by values-based practice. The article points out that both Nussbaum's approach and values-based practice recognise that people's values differ. The idea of involving different actors and service users in mental healthcare is also common in both Nussbaum's approach and values-based practice. However, there are also differences in that values-based practice relies on a 'good process' in decision-making, whereas the capabilities approach is oriented towards a 'right outcome'. However, since process and outcome are linked with each other, these two approaches do not necessarily conflict despite this difference. The article suggests that absolute rights are possible within the two approaches. It also recognises that the capabilities approach, values-based practice and human rights approach lean on liberal values and thus can be combined at least in liberal societies.
本文阐明了如何通过运用玛莎·努斯鲍姆的能力方法以及富尔福德的基于价值观的实践，将作为一项人权的思想自由理解为精神卫生服务使用者，尤其是精神病患者的一项权利并加以促进。根据努斯鲍姆的观点，思想自由似乎主要保护思考、相信和感受的能力。这种能力可以在精神卫生服务背景下通过基于价值观的实践得到促进。文章指出，努斯鲍姆的方法和基于价值观的实践都认识到人们的价值观各不相同。让不同行为者和服务使用者参与精神卫生保健的理念在努斯鲍姆的方法和基于价值观的实践中也很常见。然而，两者也存在差异，即基于价值观的实践在决策中依赖于“良好的过程”，而能力方法则以“正确的结果”为导向。然而，由于过程和结果相互关联，尽管存在这种差异，这两种方法不一定相互冲突。文章表明，在这两种方法中都可能存在绝对权利。它还认识到，能力方法、基于价值观的实践和人权方法都依赖于自由主义价值观，因此至少在自由社会中可以相互结合。
