Coercive Measures in Psychiatry Can Hardly Be Justified in Principle Any Longer-Ethico-Legal Requirements Versus Empirical Research Data and Conceptual Issues.

Autor: Richter D; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
Jazyk: angličtina
Zdroj: Journal of psychiatric and mental health nursing [J Psychiatr Ment Health Nurs] 2024 Oct 25. Date of Electronic Publication: 2024 Oct 25.
DOI: 10.1111/jpm.13129
Abstrakt: Aim: To review the scientific and empirical evidence that is usually accepted for the ethical and legal justification of coercion in psychiatry.
Method: Five key criteria are examined as follows: (1) the demonstrable existence of a mental disorder; (2) the effectiveness of psychiatric measures; (3) the use of coercion as last resort and as least possible restriction; (4) the benefit of the person affected by the coercive measure and (5) the restoration of the affected person's autonomy.
Results: (1) The existence of a demarcation between a mentally ill and a mentally healthy state cannot be confirmed; (2) Pharmacological and psychotherapeutic interventions in psychiatry are not even moderately effective; (3) Coercive measures are usually not used as last resort and as least restrictive measure; (4) Most people affected by psychiatric coercion do not benefit from the measures; (5) It is at least unclear whether autonomy is affected by a mental illness and whether it can be restored through a coercive psychiatric measure.
Discussion: None of the central ethical and legal criteria for the use of coercion in psychiatry are clearly and unambiguously fulfilled according to current research.
Implications: Psychiatric coercion can hardly be justified any longer.
(© 2024 The Author(s). Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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