کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6554668 1422281 2015 10 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Fluctuating capacity and advance decision-making in Bipolar Affective Disorder - Self-binding directives and self-determination
ترجمه فارسی عنوان
ظرفیت نوسان و پیشگیری از تصمیم گیری در اختلال عاطفی دو قطبی - دستورالعمل های خودمحور و تعیین خود
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی قانونی
چکیده انگلیسی
For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being 'protected' through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician-patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Law and Psychiatry - Volume 40, May–June 2015, Pages 92-101
نویسندگان
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