How to improve clinical practice on forced medication in psychiatric practice: Suggestions from the EUNOMIA European multicentre study

被引:23
作者
Luciano, Mario [1 ]
De Rosa, Corrado [1 ]
Sampogna, Gaia [1 ]
Del Vecchio, Valeria [1 ]
Giallonardo, Vincenzo [1 ]
Fabrazzo, Michele [1 ]
Catapano, Francesco [1 ]
Onchev, George [2 ]
Raboch, Jiri [3 ,4 ]
Mastrogianni, Anastasia [5 ]
Solomon, Zahava [6 ]
Dembinskas, Algirdas [7 ]
Nawka, Petr
Kiejna, Andrzej [8 ]
Torres-Gonzales, Francisco [9 ]
Kjellin, Lars [10 ]
Kallert, Thomas [11 ]
Fiorillo, Andrea [1 ]
机构
[1] Univ Campania L Vanvitelli, Dept Psychiat, I-80039 Naples, Italy
[2] Med Univ Sofia, Dept Psychiat, Sofia, Bulgaria
[3] Charles Univ Prague, Dept Psychiat, Fac Med 1, Prague, Czech Republic
[4] Gen Univ Hosp, Prague, Czech Republic
[5] Psychiat Hosp Thessaloniki, Stavroupoli, Greece
[6] Tel Aviv Univ, Bob Shapell Sch Social Work, Tel Aviv, Israel
[7] Univ Vilnius, Vilnius Mental Hlth Ctr, Psychiat Clin, Vilnius, Lithuania
[8] Univ Lower Silesia, Inst Psychol, Wroclaw, Poland
[9] Univ Granada, Med Fac, Dept Psychiat, Granada, Spain
[10] Orebro Univ, Fac Med & Hlth, Univ Hlth Care Res Ctr, Orebro, Sweden
[11] Psychiat Hlth Care Facil Upper Franconia GEBO, Bayreuth, Germany
关键词
Forced medication; Recommendation; Coercive measures; Procedures; COERCIVE MEASURES; INPATIENT CARE; RISK-FACTORS; MANAGEMENT; SECLUSION; ASSOCIATION; RESTRAINT; ADMISSION; EMERGENCY; COUNTRIES;
D O I
10.1016/j.eurpsy.2018.07.002
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Background: The decision to adopt forced medication in psychiatric care is particularly relevant from a clinical and ethical viewpoint. The European Commission has funded the EUNOMIA study in order to develop European recommendations for good clinical practice on coercive measures, including forced medication. Methods: The recommendations on forced medication have been developed in 11 countries with the involvement of national clinical leaders, key-professionals and stakeholders' representatives. The national recommendations have been subsequently summarized into a European shared document. Results: Several cross-national differences exist in the use of forced medication. These differences are mainly due to legal and policy making aspects, rather than to clinical situations. In fact, countries agreed that forced medication can be allowed only if the following criteria are present: 1) a therapeutic intervention is urgently needed; 2) the voluntary intake of medications is consistently rejected; 3) the patient is not aware of his/ her condition. Patients' dignity, privacy and safety shall be preserved at all times. Conclusion: The results of our study show the need of developing guidelines on the use of forced medication in psychiatric practice, that should be considered as the last resort and only when other therapeutic option have failed. (c) 2018 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:35 / 40
页数:6
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