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非自愿精神科治疗与同意权的侵蚀:对加拿大不列颠哥伦比亚省精神卫生立法的批判性话语分析。

Involuntary psychiatric treatment and the erosion of consent: A critical discourse analysis of mental health legislation in British Columbia, Canada.

机构信息

School of Nursing, University of British Columbia, Canada.

Susan Wakil School of Nursing and Midwifery, The University of Sydney, Faculty of Medicine and Health, Australia.

出版信息

Health (London). 2023 Nov;27(6):1076-1095. doi: 10.1177/13634593221096241. Epub 2022 May 9.

Abstract

The Mental Health Act (1996) is legislation that directs voluntary and involuntary psychiatric treatment for people experiencing mental health issues in British Columbia (BC), Canada. This critical discursive analysis explores how BC's Mental Health Act (1996) and the Guide to the Mental Health Act (2005) structure involuntary psychiatric treatment and illustrates how the discourses within these texts constitute people experiencing mental health issues as passive recipients of care. Understandings of people experiencing mental health issues as pathological, incapable, vulnerable and dangerous justify their need for protection and the protection of others. Protection is identified as a central legitimising discourse in the use of involuntary psychiatric treatment. Further, these texts define the roles and responsibilities of police, physicians and nurses in authorising and implementing involuntary psychiatric treatment. This analysis describes how this legislation erodes consent and entrenches social marginalisation. Alternatively, discourses of equity have potential to transform health care practices and structures that reproduce discourses of deficit, vulnerability and dangerousness, shifting towards promotion of the rights and safety of people experiencing mental health issues and crises.

摘要

《精神健康法案(1996)》是加拿大不列颠哥伦比亚省(BC)针对精神健康问题患者的自愿和非自愿精神科治疗的立法。本批判性话语分析探讨了 BC 的《精神健康法案(1996)》和《精神健康法案指南(2005)》如何构建非自愿精神科治疗,并说明了这些文本中的话语如何将经历精神健康问题的人构造成被动的护理接受者。将经历精神健康问题的人理解为病态、无能、脆弱和危险的,证明了他们需要保护和保护他人。保护被确定为使用非自愿精神科治疗的核心合法化话语。此外,这些文本定义了警察、医生和护士在授权和实施非自愿精神科治疗方面的角色和责任。这种分析描述了该立法如何侵蚀同意并使社会边缘化根深蒂固。或者,公平话语有可能改变复制缺陷、脆弱性和危险性话语的医疗保健实践和结构,转而促进经历精神健康问题和危机的人的权利和安全。

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