爱尔兰 2024 年精神健康法案:进展、问题和 Procrustean 危险。

IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Irish Journal of Medical Science Pub Date : 2024-12-01 Epub Date: 2024-09-27 DOI:10.1007/s11845-024-03806-2
Brendan D Kelly
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引用次数: 0

摘要

背景:爱尔兰的《2024 年精神健康法案》提出了自 2001 年《精神健康法案》以来最重要的精神健康立法修订:爱尔兰《2024 年精神健康法案》提出了自 2001 年《精神健康法案》以来对精神健康立法的最重大修订。目的:探讨 2024 年法案,并为后续法案提供建议:方法:回顾 2024 年法案及相关文献:结果:2024 年法案提出了一些有用的新定义(如 "精神障碍"、"治疗")和规范特定行为的条款(如 "身体约束")。为了更好地提供护理和保护权利,需要进行修订:(a)应保留拟议的非自愿入院治疗标 准,但删除 "风险 "标准;(b)治疗条款应确保精神健康立法为所有患者提供及时、负责任 的治疗;(c)有关治疗计划内容的详细规定不属于初级立法,因为初级立法不适合对个人护 理进行微观管理;(d)精神健康委员会应并入健康信息和质量管理局:2024 年法案》提出了有益的修改建议,但需要进行修订,尤其是针对缺乏决策能力和拒绝接受护理的非自愿患者,2015 年《辅助决策(能力)法》并没有(也不是为了)为他们提供解决方案。依赖于 2015 年法案、巡回法院和高等法院的复杂组合,在法律上是不可能的,在临床上也是不切实际的,并且事实上剥夺了严重精神疾病患者及其家人的权利。最终的法案可以符合 2015 年法案的原则,而不依赖于其条款,并应有利于患者和辅助人员提供精神健康护理,而精神健康护理是必不可少的,往往可以挽救生命。
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Ireland's Mental Health Bill 2024: progress, problems and Procrustean perils.

Background: Ireland's Mental Health Bill 2024 proposes the most significant revision of mental health legislation since the Mental Health Act 2001.

Aims: To explore the 2024 Bill and provide suggestions for the subsequent Act.

Methods: Review of the 2024 Bill and related literature.

Results: The 2024 Bill proposes useful new definitions (e.g., 'mental disorder', 'treatment') and provisions governing specific practices (e.g., 'physical restraint'). Revision is needed to better provide care and protect rights: (a) proposed treatment criteria for involuntary admission should be retained, but 'risk' criteria deleted; (b) treatment provisions should ensure mental health legislation provides for timely, accountable treatment for all patients; (c) detailed provisions about the content of treatment plans do not belong in primary legislation, which is ill-suited to micro-managing individual care and (d) the Mental Health Commission should be incorporated into the Health Information and Quality Authority.

Conclusions: The 2024 Bill proposes useful changes but requires revision, especially for involuntary patients who lack decision-making capacity and decline care, for whom the Assisted Decision-Making (Capacity) Act 2015 does not (and was not designed to) provide solutions. Relying on a convoluted combination of the 2015 Act, Circuit Court and High Court would be legally impossible, clinically impracticable and de facto denial of the rights of people with serious mental illness and their families. The final Act can accord with principles of the 2015 Act without relying on its provisions and should benefit patients and support staff in delivering mental health care that is essential and often life-saving.

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来源期刊
Irish Journal of Medical Science
Irish Journal of Medical Science 医学-医学:内科
CiteScore
3.70
自引率
4.80%
发文量
357
审稿时长
4-8 weeks
期刊介绍: The Irish Journal of Medical Science is the official organ of the Royal Academy of Medicine in Ireland. Established in 1832, this quarterly journal is a contribution to medical science and an ideal forum for the younger medical/scientific professional to enter world literature and an ideal launching platform now, as in the past, for many a young research worker. The primary role of both the Academy and IJMS is that of providing a forum for the exchange of scientific information and to promote academic discussion, so essential to scientific progress.
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