Reproductive psychiatric advance directives: promoting autonomy for perinatal people with serious mental illness diagnoses.

Autor: Dossett EC; Departments of Psychiatry and Behavioral Sciences and of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, 2250 Alcazar Street, Suite 2200, Los Angeles, CA, 90033, USA. edossett@dhs.lacounty.gov., Castañeda-Cudney SL; Price School of Policy, University of Southern California, Los Angeles, CA, USA., Nguyen MT; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Olgun M; Yale School of Law, Yale University, New Haven, CT, USA., Wang J; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Myrick KJ; Disability Rights California, Los Angeles, CA, USA., Hallmark L; Attorney and Subject Matter Expert Consultant Psychiatric Advance Directives, The Hallmark Compass, LLC, Sacramento, CA, USA., Saks ER; Gould School of Law, University of Southern California, Los Angeles, CA, USA.
Jazyk: angličtina
Zdroj: Archives of women's mental health [Arch Womens Ment Health] 2023 Nov 10. Date of Electronic Publication: 2023 Nov 10.
DOI: 10.1007/s00737-023-01382-5
Abstrakt: People with serious mental illness (SMI) diagnoses who become pregnant are particularly vulnerable to symptom recurrence and resulting potential lack of decision-making capacity (Taylor et al. J Psychiatr Res 104:100-107, 2018; Bagadia et al. Int J Soc Psychiatry 66:792-798, 2020). In these situations, prenatal and behavioral health providers have little legally viable guidance on what medical and/or psychiatric care the patient desires (Aneja and Arora Indian J Med Ethics V:133-139, 2020). We created a "Reproductive Psychiatric Advance Directive (PAD)," grounded in Reproductive Justice principles, that promotes patient autonomy by proactively articulating perinatal medical and psychiatric care preferences. We conducted a medical and legal literature review using two sets of terms related to (1) PADs and (2) reproductive health. We convened an expert working group of legal, medical, psychiatric, peer, and advocacy leaders and community-based organizations to develop a Reproductive PAD. Our literature review yielded no results about Reproductive PADs. We created de novo a Reproductive PAD template with sections on medical and psychiatric history, informed consent for critical medical and psychiatric care, family planning and custody preferences, and optional sections on abortion and on electroconvulsive therapy. The Reproductive PAD provides a possible legal mechanism for people of childbearing age with SMI diagnoses to articulate their medical and psychiatric care choices around reproduction and pregnancy. Future research should evaluate the Reproductive PAD as an effective tool for protecting patient autonomy during pregnancy and postpartum and guiding medical and psychiatric providers.
(© 2023. The Author(s).)
Databáze: MEDLINE
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