Ouliaris Calina, Kealy-Bateman Warren
Medical Student, University of Sydney, Sydney, NSW, Australia.
Clinical Senior Lecturer, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, NSW, and; Senior Staff Specialist Psychiatrist, Department of Psychiatry, Professor Marie Bashir Centre, Royal Prince Alfred Hospital, Camperdown, NSW, and; Graduate Student, College of Global Public Health, New York University, New York, NY, USA.
Australas Psychiatry. 2017 Dec;25(6):574-577. doi: 10.1177/1039856217726719. Epub 2017 Sep 6.
Following the recent widespread reform of mental-health legislation in Australia, psychiatric advance directives (PADs) have now been incorporated in four jurisdictions. We contextualise the potential role for PADs within the Australian legal framework and note their varying introduction across jurisdictions, with a focus on progressive legislation in the Australian Capital Territory (ACT).
The formal recognition of PADs effectively shifts the trajectory of mental-health law towards a stronger recognition of consumer autonomy, albeit to varying degrees across jurisdictions. The most inspiring of these changes may be seen in the ACT Act, where an innovative framing of PAD provisions creates a safe space for clinicians and patients to engage, build therapeutic alliances and develop appropriate frameworks for further change.
随着澳大利亚近期心理健康立法的广泛改革,精神科预先指示(PADs)现已被纳入四个司法管辖区。我们将PADs在澳大利亚法律框架中的潜在作用置于具体情境中,并指出其在不同司法管辖区的不同引入情况,重点关注澳大利亚首都直辖区(ACT)的渐进式立法。
对PADs的正式认可有效地将心理健康法的轨迹转向对消费者自主权更强有力的认可,尽管在不同司法管辖区程度有所不同。这些变化中最具启发性的或许可见于《澳大利亚首都直辖区法案》,其中对PAD条款的创新性构建为临床医生和患者提供了一个安全空间,以便他们进行互动、建立治疗联盟并制定进一步变革的适当框架。