Professor and chair of psychiatry at the Virginia Tech Carilion School of Medicine and chair of psychiatry and behavioral medicine at Carilion Clinic in Roanoke, Virginia.
Resident physician in the Department of Psychiatry and Behavioral Medicine at Carilion Clinic in Roanoke, Virginia.
AMA J Ethics. 2021 Apr 1;23(4):E292-297. doi: 10.1001/amajethics.2021.292.
Responsibly determining whether and when to use potentially lifesaving force when caring for patients who are acutely mentally ill typically requires carefully applying 2 key ethical standards. First, short-term morbidity or mortality risk must be minimized. Second, potential long-term harm to a patient who is traumatized during a forcibly performed intervention and potential long-term consequences to a patient's trust in clinicians must be seriously considered. This article suggests these minimum standards in mental health care decision making are necessary but insufficient. It is proposed that clinicians' intentions and motivations should not be grounded merely in harm minimization; rather, they should be grounded in compassion maximization. The article then proposes criteria for what compassion maximization would look like in response to a case.
当护理患有急性精神疾病的患者时，负责任地确定是否以及何时使用可能救生的力量通常需要仔细应用 2 个关键的伦理标准。首先，必须将短期发病率或死亡率风险降至最低。其次，必须认真考虑在强制干预过程中受到创伤的患者的潜在长期伤害以及患者对临床医生信任的潜在长期后果。本文认为，这些心理健康护理决策中的最低标准是必要的，但不充分。有人提出，临床医生的意图和动机不应仅仅基于将伤害降到最低；相反，它们应该基于最大化同情。然后，本文提出了在回应案例时最大化同情的标准。
