强制性住院的地域差异——伦理挑战。
Geographical variation in compulsory hospitalisation - ethical challenges.
机构信息
Centre for Medical Ethics, University of Oslo, Oslo, Norway.
Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
出版信息
BMC Health Serv Res. 2022 Dec 10;22(1):1507. doi: 10.1186/s12913-022-08798-2.
BACKGROUND
Compulsory hospitalisation in mental health care restricts patients' liberty and is experienced as harmful by many. Such hospitalisations continue to be used due to their assumed benefit, despite limited scientific evidence. Observed geographical variation in compulsory hospitalisation raises concern that rates are higher and lower than necessary in some areas.
METHODS/DISCUSSION: We present a specific normative ethical analysis of how geographical variation in compulsory hospitalisation challenges four core principles of health care ethics. We then consider the theoretical possibility of a "right", or appropriate, level of compulsory hospitalisation, as a general norm for assessing the moral divergence, i.e., too little, or too much. Finally, we discuss implications of our analysis and how they can inform the future direction of mental health services.
背景
在精神卫生保健中强制住院限制了患者的自由，并且许多人认为这是有害的。尽管科学证据有限，但由于其假定的益处，这种住院治疗仍在继续使用。观察到的强制住院治疗的地域差异令人担忧，因为在某些地区，住院治疗的比例高于或低于实际需要。
方法/讨论：我们对强制住院治疗的地域差异如何挑战医疗保健伦理的四项核心原则进行了具体的规范性伦理分析。然后，我们考虑了“适当”强制住院治疗水平的理论可能性，作为评估道德分歧（即太少或太多）的一般规范。最后，我们讨论了我们分析的影响以及它们如何为精神卫生服务的未来方向提供信息。
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