Adshead G
Institute of Psychiatry, Department of Forensic Psychiatry, London, United Kingdom.
Ann Ist Super Sanita. 1997;33(4):497-503.
The general problem with research is that its purpose does not necessarily benefit an individual patient now. In psychiatry the specific problem is that psychiatric patients may have a reduced mental competence, because of their illness. Thus the specific clinical problems of the research subjects may impede the ethical requirements of the research. To try to solve this conundrum, we may need to move away from a vision of psychiatric ethics which is rights and individual based, and find another, which understand that ethical decision are made in the context of relationship: psychiatrist-patient, patient-society, analyst-patient, psychiatrist-society.
研究的普遍问题在于其目的不一定能立刻使个体患者受益。在精神病学领域,具体问题是精神疾病患者可能因病情而心智能力下降。因此,研究对象的特定临床问题可能会阻碍研究的伦理要求。为了试图解决这一难题,我们可能需要摒弃基于权利和个体的精神病学伦理观念,转而寻找另一种观念,即认识到伦理决策是在各种关系的背景下做出的:精神病医生与患者、患者与社会、分析师与患者、精神病医生与社会。