Ethics of Informed Consent, Coercive and Preventive Medication

Ethics of Informed Consent, Coercive and Preventive Medication
Hanfried Helmchen
NeuroPsychopharmacotherapy, 5 December 2020; pp 1-16
Acknowledgement of human rights and its translation into psychiatric action is an increasingly extensive achievement of the past decades. Orientation towards the individual patient means to recognize both his/her right and capacity of self-determination as well as to consider his/her preferences. This is particularly valid in the use of psychotropic medication in problematic situations such as in coercive and in preventive medication. In view of coercive medication in life-threatening psychiatric emergencies, psychiatrists must convert a seemingly antagonism between respecting the autonomy of the mentally ill and their obligation to care into an ethically acceptable complementary solution. Medication for primary prevention confronts the psychiatrist with difficulties of informing an (almost) healthy individual in view of uncertainties of conversion rates in schizophrenia as well as of lacking drugs with satisfying efficacy in dementia. The application of psychotropic drugs in such cases is often only the last choice due to their questionable or low efficiency, unwanted effects, and other preferences of the comprehensively informed patient.

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