Helmchen Hanfried
Klinik für Psychiatrie und Psychotherapie, CBF, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland.
Nervenarzt. 2019 Jul;90(7):724-732. doi: 10.1007/s00115-019-0720-8.
Implementation of the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD). The idea of human rights developed during the era of the Enlightenment. This idea has been publicly discussed since the French Revolution of 1789 and its specification has been demanded politically. Important steps in this process were the General Declaration of Human Rights adopted by the UN in 1948 and the CRPD from 2006, which was especially relevant for psychiatric actions. Meanwhile, the idea of human rights has influenced the legislation in many countries and has thus become normatively binding, e. g. in the Basic Law of Germany, in the regulations for patient care and in the professional rules for physicians.
To sensitize for reflection on one's own actions and to gain a critical distance from the general overall opinion. Then not only the global validity of the CRPD is frequently violated, as in crisis regions but also in the everyday routine when, for example, the workload prevents psychiatric personnel from taking time for essential conversations with psychiatric patients in order to support their self-determination.
These aspects are illustrated and explained with the aid of multifarious examples from the relevant literature and from own experience.
Human rights are a regulative idea that provide a framework and direction for psychiatric actions; however, as an idea they compete with other ideas that try to control the trends of the day (the Zeitgeist) that determine daily practice. Not only the suppression of human rights from public consciousness, e. g. with the eugenics in the first third of the previous century but also their absolutization and poor implementation, as in the Italian psychiatry reform of 1978, damage psychiatric patients. Therefore, it appears necessary to sensitize psychiatrists to reflect on the Zeitgeist and its influence on their own actions and to recognize that their own opinions and actions can also influence the Zeitgeist.
联合国《残疾人权利公约》（CRPD）的实施。人权理念在启蒙时代得以发展。自1789年法国大革命以来，这一理念便开始在公开场合被讨论，并且在政治层面上要求对其进行具体阐述。这一进程中的重要举措包括联合国于1948年通过的《世界人权宣言》以及2006年通过的《残疾人权利公约》，后者对精神科行动尤为重要。与此同时，人权理念已经影响了许多国家的立法，从而具有规范约束力，例如在德国基本法、患者护理条例以及医生职业规则中。
促使人们反思自身行为，并与普遍的总体观点保持批判性距离。结果发现，不仅在危机地区，《残疾人权利公约》的全球有效性经常遭到侵犯，在日常工作中亦是如此，例如，当工作量使得精神科工作人员无暇与精神科患者进行必要的交谈以支持他们的自主决定时。
借助相关文献和自身经验中的各种实例对这些方面进行说明和解释。
人权是一种规范性理念，为精神科行动提供框架和方向；然而，作为一种理念，它与其他试图控制决定日常实践的时代潮流（时代精神）的理念相互竞争。不仅上个世纪前三分之一时期的优生学等将人权从公众意识中压制下去，而且1978年意大利精神科改革中人权的绝对化和糟糕实施也对精神科患者造成了伤害。因此，似乎有必要促使精神科医生反思时代精神及其对自身行为的影响，并认识到他们自己的观点和行动也会影响时代精神。
Zotero 插件