Berard Karine
Psypro Lyon, 20 rue du Général-Dayan, 69100 Villeurbanne, France.
Soins Psychiatr. 2021 Mar-Apr;42(333):12-15. doi: 10.1016/j.spsy.2021.03.003. Epub 2021 Mar 23.
Medical paternalism has given way to the autonomy of the patient, who remains master of the decisions he makes concerning his health. His consent, free and informed, has no value unless it is preceded by information adapted to his degree of understanding. The notion of consent raises the question of freedom, and therefore of the autonomy left to patients in their choices. Individual freedom occupies a particular place in psychiatry where it comes into confrontation with constraint. The tensions generated must lead caregivers to ask themselves the right questions in accordance with the principles of medical ethics.
医疗家长主义已让位于患者的自主权，患者仍是其自身健康相关决策的主导者。他的同意，需是自由且知情的，但若在此之前没有根据其理解程度提供相应信息，这种同意则毫无价值。同意的概念引发了自由的问题，进而涉及患者在选择时所剩的自主权问题。个人自由在精神病学领域占据特殊地位，在那里它与强制约束形成对峙。由此产生的紧张关系必然促使医护人员依据医学伦理原则来审视正确的问题。
