Coerced or involuntary treatment comprises an integral, often positive component of treatment for addictive disorders. By the same token, coercion in health care raises numerous ethical, clinical, legal, political, cultural, and philosophical issues. In order to apply coerced care effectively, health care professionals should appreciate the indications, methods, advantages, and liabilities associated with this important clinical modality. An expert panel, consisting of the Addiction Committee of the Group for the Advancement of Psychiatry, listed the issues to be considered by clinicians in considering coerced treatment. In undertaking this task, they searched the literature using Pubmed from 1985 to 2005 using the following search terms: addiction, alcohol, coercion, compulsory, involuntary, substance, and treatment. In addition, they utilized relevant literature from published reports. In the treatment of addictions, coercive techniques can be effective and may be warranted in some circumstances. Various dimensions of coercive treatment are reviewed, including interventions to initiate treatment; contingency contracting and urine testing in the context of psychotherapy; and pharmacological methods of coercion such as disulfiram, naltrexone, and the use of a cocaine vaccine. The philosophical, historical, and societal aspects of coerced treatment are considered.

译文

强迫或非自愿治疗包括成瘾性疾病治疗的一个不可或缺的,通常是积极的组成部分。同样,医疗保健中的胁迫引发了许多道德,临床,法律,政治,文化和哲学问题。为了有效地应用强制护理,医疗保健专业人员应了解与这种重要临床方式相关的适应症,方法,优势和责任。由精神病学促进小组成瘾委员会组成的专家小组列出了临床医生在考虑强制治疗时应考虑的问题。在执行此任务时,他们使用Pubmed 1985年2005年使用以下搜索词搜索文献: 成瘾,酒精,胁迫,强制性,非自愿,物质和治疗。此外,他们还利用了已发表报告中的相关文献。在治疗成瘾时,强制技术可能是有效的,并且在某些情况下可能是必要的。审查了胁迫治疗的各个方面,包括启动治疗的干预措施; 心理治疗背景下的应急合同和尿液测试; 以及胁迫的药理学方法,例如双硫仑,纳曲酮和可卡因疫苗的使用。考虑了强迫治疗的哲学,历史和社会方面。

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