Kortmann F A
Academisch Ziekenhuis, afd. Psychiatrie, Nijmegen.
Ned Tijdschr Geneeskd. 1997 Aug 30;141(35):1686-8.
Three years after the implementation of the Dutch Act on Compulsory Admission to Psychiatric Hospitals an evaluation was made. It shows that the law has reinforced the patients' rights to self-determination, but that actual practice is not yet fully according to the law. For the latter the reporters blame the complexity of the law and the inadequate manner in which the law was introduced. An evaluation of the effects of a similar law in the USA puts this issue in a different light. It shows that caregivers and judges do not let the patient's rights to autonomy prevail if this is not in the patient's best interests. The right to self-determination, expected in the sixties and seventies to become a revolution in psychiatry appears to be merely 'a near-revolution'. The moral importance of caring for a psychiatric patient outweighs the respect for his or her right to self-determination.
荷兰《精神病院强制收治法案》实施三年后进行了一次评估。评估显示，该法律强化了患者的自决权，但实际操作尚未完全依法进行。对于后者，报告撰写者将其归咎于法律的复杂性以及法律引入方式的不足。对美国一项类似法律效果的评估则从不同角度看待了这个问题。评估表明，如果这不符合患者的最大利益，护理人员和法官不会让患者的自主权优先。自决权在六七十年代被期望成为精神病学领域的一场革命，但似乎仅仅是“一场接近革命的变革”。照顾精神病患者的道德重要性超过了对其自决权的尊重。
