Klinische Ethik in der Psychiatrie: State of the Art

Zusammenfassung

Ziel: Überblick zur klinischen Ethik (Konsultation) in der Psychiatrie.

Methode: Systematische Literaturrecherche in Datenbanken vor dem Hintergrund der modellhaften Implementierung von Ethikkonsultation in einer psychiatrischen Universitätsklinik.

Ergebnisse: Berichte zur Ethikkonsultation in der Psychiatrie wurden nur sporadisch publiziert; dem stehen aktuelle Erfahrungen gegenüber, die erheblichen Bedarf belegen.

Schlussfolgerungen: Bedarf an Erprobung und Begleitforschung zur ethischen Unterstützung in der Psychiatrie. Bisher bewährt: patienten- sowie teamorientierte ethische Unterstützung.

Abstract

Aim: Overview on Clinical Ethics Consultation in Psychiatry.

Method: Systematic literature search in data bases (PubMed, Web of Knowledge, SpringerLink, PubPsych, PsychSpider und PsycINFO) against the background of practical experiences with pilot model of implementation of Ethics Consultation in one psychiatric university hospital.

Results: Reports on Ethics Consultation in Psychiatry were published only sporadically. This is contrasted by recent experiences showing considerable needs for ethics support in Child and Adolescent Psychiatry, Adult as well as Forensic Psychiatry.

Discussion: This somewhat “late” development of Ethics Consultation in Psychiatry (compared with somatic medicine) might have structural reasons (lacking resources), be related to strong compensatory competencies of psychiatric staff, esp. regarding communication or legal knowledge, but could also relate to an under-estimation (“under-diagnostic”) of ethical problems in psychiatric patient care – both, in the eyes of psychiatric insiders, as well as seen from the outside.

Conclusions: Needs for model projects and accompanying research on Ethics Consultation in Psychiatry. Proved in practice: patient- as well as team-oriented ethics support.

Schlüsselwörter

klinische Ethikkonsultation - ethische Unterstützung - Psychiatrie - Literaturrecherche

Keywords

clinical ethics consultation - ethics support - psychiatry - literature search

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