Bursztajn H, Gutheil T G, Hamm R M, Brodsky A, Mills M J
Program in Psychiatry and the Law, Massachusetts Mental Health Center, Boston 02115.
Psychiatr Q. 1988 Fall;59(3):165-81. doi: 10.1007/BF01064241.
Seventy-one commitment-seeking decisions made by 36 clinicians in a state-funded mental health center were studied to determine the extent to which clinicians attend to legally mandated "dangerousness" criteria in seeking commitment. A previous finding that clinicians rely largely on the dangerousness criteria was replicated. In addition, clinicians were found to be sensitive to clinical indicators of the patient's need for treatment, a question which is central to the parens patriae approach to involuntary hospitalization. Further, patients who were judged to be more seriously ill or more dangerous were more likely to retract their requests for discharge. This finding suggests that the patient's request for release and the psychiatrist's petition for commitment together constitute an interactive, transactional process in which the clinician's and the patient's views of the patient's need for hospitalization influence each other.
对一家州立心理健康中心的36名临床医生做出的71项寻求强制住院的决定进行了研究，以确定临床医生在寻求强制住院时遵循法律规定的“危险性”标准的程度。之前关于临床医生主要依赖危险性标准的研究结果得到了重复验证。此外，还发现临床医生对患者治疗需求的临床指标很敏感，这是家长式非自愿住院治疗方法的核心问题。此外，被判定病情更严重或更危险的患者更有可能撤回出院请求。这一发现表明，患者的出院请求和精神科医生的强制住院申请共同构成了一个互动的、交易性的过程，在这个过程中，临床医生和患者对患者住院需求的看法相互影响。
