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在澳大利亚精神卫生立法下,强制住院的精神病人是否有权就其治疗获得第二次意见?

Do compulsory mental health patients have a right to receive a second opinion on their treatment under Australian mental health legislation?

机构信息

Australian Centre for Health Law Research, School of Law, Faculty of Business and Law, Queensland University of Technology, Brisbane, QLD, Australia.

School of Law, Faculty of Business and Law, Queensland University of Technology, Brisbane, QLD, Australia.

出版信息

Aust N Z J Psychiatry. 2024 Nov;58(11):927-929. doi: 10.1177/00048674241267219. Epub 2024 Aug 2.

Abstract

We reviewed Australian mental health legislation to determine what obligations it places on psychiatrists to facilitate second opinions for compulsory patients who request them. Only four jurisdictions-Australian Capital Territory, Queensland, Victoria, and Western Australia-have legislated for 'patient-initiated' second opinions. Within these four regimes, there is variation in important aspects of the second opinion process, and there is a general absence of direction given to the second opinion providers. Based on research showing the variability of second opinion provision under New Zealand mental health legislation, we argue that this absence is likely to result in significant variation in the quality and depth of second opinions provided in Australia. We argue that New South Wales, the Northern Territory, South Australia, and Tasmania should consider formal provision for patient-initiated second opinions in their mental health legislation. We believe that such legislation ought to be aware of the barriers patients may face in accessing second opinions, and avoid exacerbating these barriers as Queensland's legislation appears to. Also, we argue that research on current practice in Australia should be conducted to better understand the effects of legislation on second opinions, and to help determine what amounts to best practice.

摘要

我们回顾了澳大利亚的精神卫生立法,以确定它对精神病医生有哪些义务,以方便那些要求的强制患者进行第二意见。只有四个司法管辖区——澳大利亚首都领地、昆士兰州、维多利亚州和西澳大利亚州——为“患者发起”的第二意见立法。在这四个制度中,第二意见程序的重要方面存在差异,而且对第二意见提供者没有给予一般性指导。根据研究表明,新西兰精神卫生立法下第二意见提供的可变性,我们认为这种缺失可能导致澳大利亚提供的第二意见的质量和深度存在显著差异。我们认为,新南威尔士州、北领地、南澳大利亚州和塔斯马尼亚州应该考虑在其精神卫生立法中为患者发起的第二意见提供正式规定。我们认为,此类立法应该意识到患者在获取第二意见时可能面临的障碍,并避免像昆士兰州的立法那样加剧这些障碍。此外,我们还认为,应该在澳大利亚进行关于当前实践的研究,以更好地了解立法对第二意见的影响,并帮助确定什么是最佳做法。

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本文引用的文献

1
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J Psychiatr Pract. 2018 Nov;24(6):434-442. doi: 10.1097/PRA.0000000000000343.
2
Lessons from export to New Zealand of the second opinion appointed doctor scheme.
BJPsych Bull. 2015 Apr;39(2):69-73. doi: 10.1192/pb.bp.113.046540.

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