In psychiatry, caregivers try to get free and informed consent of patients, but often feel required to restrict freedom and to use coercion. The present article develops ethical advice given by an Ethics Committee for Mental Health Care. The advice recommends an ethical ideal of shared deliberation, consisting of information, motivation, consensus and evaluation. For the exceptional use of coercion, the advice develops three criteria, namely incapacity to deliberate, threat of serious harm and proportionality between harm and coercion. The article also discusses the viewpoints of the ethical advice and of the European Convention on Human Rights and Biomedicine: is the advice in agreement with the Convention and can the advice refine the guidelines of the Convention for the particular context of psychiatry? Although the Convention emphasises the autonomy of the individual patient, whereas the advice focuses on the relationships between the partners involved, the advice enjoys a complementary and supportive function in the application of the Convention.

译文

在精神病学中,护理人员试图获得患者的自由和知情同意,但经常感到需要限制自由和使用胁迫。本文提出了由精神卫生护理伦理委员会提供的伦理建议。该建议建议共享审议的道德理想,包括信息,动机,共识和评估。对于强制的特殊使用,该建议制定了三个标准,即无能力进行故意,严重伤害的威胁以及伤害与胁迫之间的相称性。本文还讨论了《道德建议》和《欧洲人权与生物医学公约》的观点: 该建议是否与《公约》一致,该建议能否针对精神病学的特定背景完善《公约》的指导方针?尽管《公约》强调患者个人的自主权,而《建议》侧重于所涉伙伴之间的关系,但《建议》在适用《公约》方面具有补充和支持作用。

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