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寻求强制住院治疗的决定。法律背景下的精神科决策。

Decision to seek commitment. Psychiatric decision making in a legal context.

作者信息

Appelbaum P S, Hamm R M

出版信息

Arch Gen Psychiatry. 1982 Apr;39(4):447-51. doi: 10.1001/archpsyc.1982.04290040047007.

Abstract

In seeking to commit patients, psychiatrists have often been accused of pursuing ends other than those prescribed by the law, but empiric data have been lacking on those factors that influence commitment decisions. In this study 34 clinicians, most of whom were psychiatrists, responded to 65 requests by voluntary patients for discharge from the hospital. The legal criteria governing commitment were found to be significantly related to the decision. Those nonlegal criteria that seemed most consistently to play a significant role in the decision seemed closely related to one of the legal criteria. The clinicians' affective responses to their patients and the patients' personality traits did not play a significant role in the decision. These findings suggest that this group of clinicians was acting in substantial accordance with the dangerousness requirements of the commitment law.

摘要

在试图对患者进行强制住院治疗时,精神科医生常常被指责追求法律规定之外的目的,但一直缺乏关于影响强制住院治疗决策因素的实证数据。在这项研究中,34名临床医生(其中大多数是精神科医生)回应了65名自愿住院患者的出院请求。结果发现,有关强制住院治疗的法律标准与该决策显著相关。那些似乎在决策中最始终如一地发挥重要作用的非法律标准,似乎与其中一项法律标准密切相关。临床医生对患者的情感反应以及患者的个性特征在决策中并未发挥重要作用。这些发现表明,这群临床医生的行为在很大程度上符合强制住院治疗法对危险性的要求。

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