Mario Luciano1, Corrado De Rosa1, Gaia Sampogna1, Valeria Del Vecchio1, Vincenzo Giallonardo1, Michele Fabrazzo1, Francesco Catapano1, George Onchev2, Jiri Raboch3, Anastasia Mastrogianni4, Zahava Solomon5, Algirdas Dembinskas6, Petr Nawka7, Andrzej Kiejna8, Francisco Torres-Gonzales9, Lars Kjellin10, Thomas Kallert11, Andrea Fiorillo12. 1. Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy. 2. Department of Psychiatry, Medical University Sofia, Sofia, Bulgaria. 3. Department of Psychiatry, First Faculty of Medicine Charles University and General University Hospital, Prague, Czech Republic. 4. Psychiatric Hospital of Thessaloniki, Greece. 5. Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel. 6. Psychiatric Clinic, Vilnius Mental Health Centre, University of Vilnius, Vilnius, Lithuania. 7. Psychiatric private practice, Dresden, Germany. 8. Institute of Psychology, University of Lower Silesia, Wroclaw, Poland. 9. Department of Psychiatry, Medical Faculty, University of Granada, Granada, Spain. 10. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 11. Psychiatric Health Care Facilities of Upper Franconia (GEBO), Bayreuth, Germany. 12. Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy. Electronic address: andrea.fiorillo@unicampania.it.
Abstract
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.
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.
Authors: G Maina; G Rosso; C Carezana; E Mehanović; F Risso; V Villari; L Gariglio; M Cardano Journal: Ann Gen Psychiatry Date: 2021-01-07 Impact factor: 3.455