Recovery from Mental Illness Ethics 101

PATIENT EMPOWERMENT IS ONE OF THE WAYS WE CAN HELP PATIENTS HELP THEMSELVES.

BUT THERE ARE RISKS IN DOING SO. READ BELOW:


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On the subject of patient self-management the authors of this article published in Bioethics Volume 21 Issue 5 Page 243-250, June 2007 point out that,


“Four central ethical issues can be identified:

1) insufficient patient/family access to preparation that will optimize their competence to SM without harm to themselves,

2) lack of acknowledgement that an ethos of patient empowerment can mask transfer of responsibility beyond patient/family competency to handle that responsibility,

3) prevailing assumptions that preparation for SM cannot result in harm and that its main purpose is to deliver physician instructions, and

4) lack of standards for patient selection, which has the potential to exclude individuals who could benefit from learning to SM. Technology assessment offers one framework through which to examine available data about efficacy of patient SM and to answer the central question of what conditions must be put in place to optimize the benefits of SM while assuring that potential harms are controlled.



Reference: BARBARA K. REDMAN from the Wayne State University, and University of Pennsylvania Center for Bioethics

Barbara K. Redman, PhD, RN, FAAN, Dean and Professor, College of Nursing, Wayne State University, Cohn Building, Suite 12, 5557 Cass Avenue, Detroit, MI 48202.

RESPONSIBILITY FOR CONTROL; ETHICS OF PATIENT PREPARATION FOR SELF-MANAGEMENT OF CHRONIC DISEASE, Wayne State University, and University of Pennsylvania Center for Bioethics



Web reference of the summary: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1467-8519.2007.00550.x

Excerpt from an important review of an important book

Read the entire story at http://psychservices.psychiatryonline.org/cgi/content/full/58/8/1128



"Psychiatry is in an era of change not only in terms of new scientific models of mental health but also in values-based models of psychiatric service. Our nation's first two commissions on mental health were appointed by President Kennedy in 1963 and by President Carter in 1978. The third commission, the New Freedom Commission appointed by George W. Bush, sets a vision for recovery in its budget-neutral document, Achieving the Promise"

.....

"If recovery is a scientific model, then more review could have been invested not only in those areas of the field where recovery easily informs our understanding of illness and outcome but also in areas where recovery has challenges in explaining service provision and certain other phenomena. If recovery is a values-based model, then additional attention to the ethics of recovery or the complex issues of how recovery is balanced by public and personal safety would have helped".


Reference:

Jabbarpour, Yad. M. (Book review) Psychiatr Serv 58:1128, August 2007 American Psychiatric Association

Book Reviewed
Recovery From Severe Mental Illnesses: Research Evidence and Implications for Practice, Volumes 1 and 2
edited by Larry Davidson, Courtenay Harding, and LeRoy Spaniol; Boston, Center for Psychiatric Rehabilitation, 2005, 511 pages and 448 pages, $49.95 each, softcover