Matthé Scholten1, Jakov Gather2,3, Jochen Vollmann2. 1. Institut für Medizinische Ethik und Geschichte der Medizin, Ruhr-Universität Bochum, Markstr. 258a, 44799, Bochum, Deutschland. matthe.scholten@rub.de. 2. Institut für Medizinische Ethik und Geschichte der Medizin, Ruhr-Universität Bochum, Markstr. 258a, 44799, Bochum, Deutschland. 3. Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum, Ruhr-Universität Bochum, Bochum, Deutschland.
Abstract
BACKGROUND: The interpretation of Article 12 of the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) by the UN Committee on the Rights of Persons with Disabilities led to a controversy over the implementation of the article in psychiatry. OBJECTIVE: How can Article 12 CRPD be implemented in psychiatry in an ethically justifiable way? MATERIAL AND METHOD: An empirically and legally informed conceptual and ethical analysis was carried out. RESULTS: The suggested combined supported decision making model ensures the recognition of people with mental disorders as persons before the law, their equal treatment in the informed consent process and the provision of supported decision making. According to this model, coercive treatment can only be carried out in accordance with the will and preferences of the person and is subject to further conditions of proportionality and review by an independent body. CONCLUSION: The combined supported decision making model makes an ethically justifiable implementation of Article 12 CRPD possible in psychiatry.
BACKGROUND: The interpretation of Article 12 of the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) by the UN Committee on the Rights of Persons with Disabilities led to a controversy over the implementation of the article in psychiatry. OBJECTIVE: How can Article 12 CRPD be implemented in psychiatry in an ethically justifiable way? MATERIAL AND METHOD: An empirically and legally informed conceptual and ethical analysis was carried out. RESULTS: The suggested combined supported decision making model ensures the recognition of people with mental disorders as persons before the law, their equal treatment in the informed consent process and the provision of supported decision making. According to this model, coercive treatment can only be carried out in accordance with the will and preferences of the person and is subject to further conditions of proportionality and review by an independent body. CONCLUSION: The combined supported decision making model makes an ethically justifiable implementation of Article 12 CRPD possible in psychiatry.
Authors: Melvyn Colin Freeman; Kavitha Kolappa; Jose Miguel Caldas de Almeida; Arthur Kleinman; Nino Makhashvili; Sifiso Phakathi; Benedetto Saraceno; Graham Thornicroft Journal: Lancet Psychiatry Date: 2015-07-05 Impact factor: 27.083