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精神病学中的强制用药:丹麦上诉委员会不尊重患者权利与法律

Forced Medication in Psychiatry: Patients' Rights and the Law Not Respected by Appeals Board in Denmark.

作者信息

Gøtzsche Peter C, Vinther Simon, Sørensen Anders

机构信息

Institute for Scientific Freedom, Copenhagen https://www.scientificfreedom.dk/.

出版信息

Clin Neuropsychiatry. 2019 Oct;16(5-6):229-233. doi: 10.36131/clinicalnpsych2019050606.

Abstract

OBJECTIVE

We investigated if the law and the patients' rights are being respected in Denmark when patients appeal forced medication orders.

METHOD

We assessed 30 consecutive cases described on the webpage of the Psychiatric Appeals Board.

RESULTS

No clear and convincing evidence was presented in any case that the proposed treatment was in the patient's best interests. Furthermore, according to Danish law, forced medication should be with drugs with the fewest possible adverse effects, but this condition was violated in 29 of the 30 cases (97%).In seven cases (23%), where the board disagreed with an earlier decision made by the Psychiatric Patients' Complaints Board and resolved that the conditions for forced treatment with an antipsychotic had not been met, the issues were formal and minor, and the Appeals Board argued, also in these cases, that force was justified because the patient was insane and that the prospect of cure or a significant and decisive improvement in the condition would otherwise be significantly impaired. This view lacks support in reliable science.The board seems mainly to have a cosmetic function, rubber stamping what the psychiatrists want. It focused on uncontroversial issues it could easily check and not on what is important for patients.

CONCLUSIONS

Patients' rights and the law were not being respected. We suggest forced medication be abandoned, in accordance with the United Nations Convention on the Rights of Persons with Disabilities.

摘要

目的

我们调查了在丹麦,当患者对强制用药令提出上诉时,法律和患者权利是否得到尊重。

方法

我们评估了精神病上诉委员会网页上描述的连续30个案例。

结果

在任何案例中,均未提供明确且令人信服的证据表明所提议的治疗符合患者的最大利益。此外,根据丹麦法律,强制用药应使用副作用尽可能少的药物,但在30个案例中的29个(97%)违反了这一条件。在7个案例(23%)中,委员会不同意精神病患者投诉委员会先前做出的决定,并认定使用抗精神病药物进行强制治疗的条件未得到满足,这些问题是形式上的且较为轻微,而且上诉委员会在这些案例中也主张强制是合理的,因为患者患有精神病,否则治愈的前景或病情的显著决定性改善将受到严重损害。这一观点缺乏可靠科学依据。该委员会似乎主要起装点门面的作用,对精神病医生的要求盖章通过。它关注的是那些它能轻易核实的无争议问题,而非对患者重要的问题。

结论

患者权利和法律未得到尊重。我们建议根据《联合国残疾人权利公约》放弃强制用药。

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