Ethik in der Psychiatrie Probleme und Perspektiven
Ausgabe: 3/2008
54. Jahrgang
Ethik in der Psychiatrie
The article first introduces general norms for moral orientation (respect for human dignity, prevention of physical danger), which have been specified and accepted in medical codices as ethical principles guiding the actions of doctors, augmented by principles specific to physicians (the well-being of the patient, confidentiality, etc.). The article moves on to consider the binding force of these norms in the context of far-reaching social changes. Of central ethical significance is a change in the way we perceive the mentally ill patients, leading to an acceptance focusing on his inherent dignity, i. e. considering seriously his needs as well as his specific vulnerability and, at the same time, respecting his right to make his own choices. However, since mental illnesses, more frequently than other illnesses, limit the patients capacity for self-determination that we assess as his capacity to give consent, the psychiatrist has a particular responsibility accurately to judge the psychiatric patients capacity to consent. Conflicts can arise when ethical principles such as acting for the patients well-being and respecting his will, or individual well-being and public welfare contradict one another in specific circumstances. Such conflicts are illustrated by several examples (forced treatment, psychiatric longterm medication, testing of psycho-pharmaceutical drugs with placebo controls, usage of anti-dementia drugs).
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