Psychiatrist at Neuropsychiatric Associates in Austin, Texas.
AMA J Ethics. 2021 Apr 1;23(4):E326-334. doi: 10.1001/amajethics.2021.326.
This article focuses on uses of force in clinical settings after a triggering event-a behavioral or medical crisis-and considers how force should be implemented. The clinical stakes are high, as force can undermine therapeutic capacity in patient-clinician relationships, exacerbate moral distress, and erode trust. Yet they are rarely discussed. This article explores use of force rather than merely use of force and considers how and by whom force should be executed; the nature and scope of goals, motivations, and protocols that should guide caregivers who must implement force protocols; and what a good compassionate force protocol might look like.
本文重点关注在触发事件（行为或医疗危机）后临床环境中的武力使用，并考虑如何实施武力。武力的临床风险很高，因为武力可能会破坏医患关系中的治疗能力，加剧道德困境，并破坏信任。然而，这些问题很少被讨论。本文探讨了武力的使用，而不仅仅是武力的使用，并考虑了应该如何以及由谁来执行武力；应该指导必须执行武力协议的护理人员的目标、动机和协议的性质和范围；以及一个好的有同情心的武力协议可能是什么样子。
