Reflexionando sobre las medidas coercitivas en salud mental. Análisis bioético  y antropológico

Sergio Ramos Pozón

doi:10.14198/cuid.2021.59.11

Autores/as

Sergio Ramos Pozón

DOI:

https://doi.org/10.14198/cuid.2021.59.11

Palabras clave:

medidas coercitivas, salud mental, enfermería, bioética

Resumen

Las medidas coercitivas en salud mental implican un significante sufrimiento para pacientes, familiares y profesionales. Generan mucho debate ético sobre su legitimidad y/o su rechazo. Estos desafíos éticos para Enfermería han parcialmente delimitados. Los aspectos teóricos, filosóficos y éticos que se derivan de su uso han sido objeto de estudio por parte de Enfermería, aunque han sido analizados superficialmente. Este artículo arroja luz sobre esa laguna y explica los conceptos “vulnerabilidad”, “mejor interés”, y “competencia”. Además, se exponen algunas teorías éticas para fundamentar la relación asistencial. Por último, se presentan algunos estudios empíricos sobre la percepción de los afectados por estas prácticas coercitivas.

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- Appelbaum P. (2007). Clinical practice. Assessment of patients' competence to consent to treatment. N Engl J Med., 1;357(18):1834-40.

- Bolt J. (2019). The concept of vulnerability in medical ethics and philosophy. Philosophy, Ethics, and Humanities in Medicine, 4:6.

- Brady N, Spittal M, Brophy L, y Harvey C. (2017) Patients’ experiences of restrictive interventions in Australia: Findings from the 2010 Australian survey of psychosis. Psychiatr Serv, 68(9):966–9.

- Buchanan A., y Brock D. (1989). Deciding for Others. The Ethics of Surrogate Decision Making. New York: Cambridge University Press.

- Calcedo A., Fructuoso J., Martinez J., et al. (2020) A meta-review of literature reviews

assessing the capacity of patients with severe mental disorders to make decisions about their healthcare, BMC Psychiatry, 20:339.

- Cestari V, Moreira T, Pessoa V, et al. (2017). The essence of care in health vulnerability: a Heideggerian construction. Revista Brasileira de Enfermagem, 70(5):1112-1116.

- Chambers M, Kantaris X, Guise V, y Välimäki M. (2015). Managing and caring for distressed and disturbed service users: The thoughts and feelings experienced by a sample of English mental health nurses. J Psychiatr Ment Health Nurs, 22(5):289–97.

- Clarck B., y Preto P. (2018). Exploring the concept of vulnerability in health care. CMAJ. March 19;190:E308-9. doi: 10.1503/cmaj.180242.

- Conill J. (2006). Ética hermenéutica. Madrid: Tecnos.

- Cortina A. (2007). Ethica cordis. Isegoría, 37:113-126.

- Dahan S, Levi G, Behrbalk P, et al. (2018). The Impact of ‘Being There’: Psychiatric Staff Attitudes on the Use of Restraint. Psychiatr Q, 89(1):191–9.

- Diekema D. (2011). Revisiting the Best Interest Standard: Uses and Misuses. The Journal of Clinical Ethics, 22(2):128-133.

- Doedens P, Vermeulen J, Boyette L, et al. (2020). Influence of nursing staff attitudes and characteristics on the use of coercive measures in acute mental health services—A systematic review. J Psychiatr Ment Health Nurs, 27(4):446-459.

- Førde R., Norvoll R., Hem M., y Pedersen R. (2016). Next of kin’s experiences of involvement during involuntary hospitalisation and coercion. BMC Medical Ethics,17:76.

- Gabriel A. (2016). Perceptions and Attitudes towards Involuntary Hospital Admissions of Psychiatric Patient. J Psych Behav Sci, 2(1):013

- Gerace A., y Cochran E. (2019). Perceptions of nurses working with psychiatric consumers regarding the elimination of seclusion and restraint in psychiatric inpatient settings and emergency departments: An Australian survey. Int J Ment Health Nurs, 28(1):209–25.

- Goodin R. (1985). Protecting the vulnerable. Chicago: University of Chicago Press.

- Gooding P., McSherry B., Roper C., y Grey F. (2018). Alternatives to Coercion in Mental Health Settings: A Literature Review. Melbourne Social Equity Institute. Disponible en: https://socialequity.unimelb.edu.au/__data/assets/pdf_file/0012/2898525/Alternatives-to-Coercion-Literature-Review-Melbourne-Social-Equity-Institute.pdf

- Gowda G, Lepping P, Ray S., et al. (2018). Clinician attitude and perspective on the use of coercive measures in clinical practice from tertiary care mental health establishment – A cross‑sectional study. Indian J Psychiatry, 59(4):2017–8.

- Haugom E., Ruud T., y Hynnekleiv T. (2019). Ethical challenges of seclusion in psychiatric inpatient wards: a qualitative study of the experiences of Norwegian mental health professionals. BMC Health Services Research, 19:879.

- Hem M, Molewijk B., y Pedersen R. (2014). Ethical challenges in connection with the use of coercion: a focus group study of health care personnel in mental health care. BMC Medical Ethics, 15:82.

- Hem M., Gjerberg E., Husum T., y Pedersen R. (2018). Ethical challenges when using coercion in mental healthcare: A systematic literature review. Nurs Ethics, 25(1):92–110.

- Honneth A. (1992). Integridad y desprecio. Motivos básicos de una concepción de la moral desde la teoría del reconocimiento. Isegoría, núm. 5.

- Honneth A. (1996). Reconocimiento y obligaciones morales. Revista Internacional de Filosofía Política, núm. 8.

- Jankovi J., Yeele K., Katsako Ch., et al. (2011). Family Caregivers’ Experiences of Involuntary Psychiatric Hospital Admissions of Their Relatives – a Qualitative Study. PLoS One, 6(10):e25425.

- Kallert T, Mezzich J, y Monahan J (eds) (2011). Coercive treatment in psychiatry: clinical, legal and ethical aspects. Oxford: Wiley-Blackwell.

- Katsakou C, Rose D, Amos T, et al. (2012). Psychiatric patients’ views on why their involuntary hospitalisation was right or wrong: A qualitative study. Soc Psychiatry Psychiatr Epidemiol, 47(7):1169–79.

- Katsakou C., Marougka S., Garabette J., et al. (2011). Why do some voluntary patients feel coerced into hospitalization? A mixed-methods study. Psychiatry Res, 15;187(1-2):275-82.

- Kinner S, Harvey C, Hamilton B, et al. (2017). Attitudes towards seclusion and restraint in mental health settings: Findings from a large, community-based survey of consumers, carers and mental health professionals. Epidem Psychiatr Sci, 26(5):535–44.

- Kong C. (2017). Mental Capacity in Relationship. Cambridge: Bioethics and Law.

- Kopelman L. (1997) The Best-Interest Standard as Threshold, Ideal, and Standard of Reasonableness. The Journal of Medicine and Philosophy, 22:271-289.

- Kopelman L. (2007). The Best Interests Standard for Incompetent or Incapacitated Persons of All Ages. Childhood Obesity, 187-196.

- Levine C. (2004). The Limitations of “Vulnerability” as a Protection for Human Research Participants. American Journal of Bioethics, 4(3):44-49.

- Looi G, Engström A, y Sävenstedt S. (2015). A self-destructive care: Self-reports of people who experienced coercive measures and their suggestions for alternatives. Issues Ment Health Nurs, 36(2):96–103.

- Moratalla D. (2007). Bioética y hermenéutica. La aportación de Paul Ricoeur a la bioética. Veritas, 17(2):281-312.

- Moratalla D. (2016). Bioética hermenéutica. En: Ferrer J, Lecaros J, y Molins R. (coords). Bioética: el pluralismo de la fundamentación. Madrid: Universidad Pontífica de Comillas.

- Muir E., O’Kane D., y Oster C. (2018). Fear and blame in mental health nurses’ accounts of restrictive practices: Implications for the elimination of seclusion and restraint. International Journal of Mental Health Nursing, 27:1511–1521.

- Nanjegowda B., Gowda G., y Gowda M. (2019). Alternatives to use of restraint: A path toward humanistic care. Alternatives to use of restraint: A path toward humanistic care. Indian J Psychiatry, 61:S693-7.

- Norvoll N., Hem N., y Pedersen R. (2017). The Role of Ethics in Reducing and Improving the Quality of Coercion in Mental Health Care. HEC Forum, 29:59–74.

- Pons E., Salvador L., Calcedo A., et al. (2020). The capacity of schizophrenia and bipolar disorder individuals to make autonomous decisions about pharmacological treatments for their illness in real life: A scoping review. Health Sci Rep, 00:e179. https://doi.org/10.1002/hsr2.179

- Ramos S., y Robles B. (2015). La relación médico-paciente en salud mental: el documento de voluntades anticipadas y la planificación anticipada de las decisiones. Rehabilitación Psicosocial, 12(1):18-24.

- Ramos S. (2015). Las voluntades anticipadas en salud mental: hechos y valores. Revista de Psiquiatría y Salud mental, 08:244-245.

- Rakhmatullina M., Taub A., y Jacob Th. (2013). Morbidity and Mortality Associated with the Utilization of Restraints. A Review of Literature. Psych Quarterly, 84:499–512.

- Raveesh B, Pathare S, Noorthoorn E, et al. (2016). Staff and caregiver attitude to coercion in India. Indian J Psychiatry, 58(6):221–9.

- Rendtorff J. (2002). Basic ethical principles in European bioethics and biolaw: Autonomy, dignity, integrity and vulnerability-Towards a foundation of bioethics and biolaw. Medicine, Health Care and Philosophy, 5:235-244.

- Rogers W, Mackenzie C, y Dodds S. (2012). Why bioethics needs a concept of vulnerability. Int J Fem Approaches Bioeth, 5(2):11–38.

- Salter E. (2012). Deciding for a child: a comprehensive analysis of the best interest standard. Theor Medi Bioethi, 33:179-98.

- Santi M. (2015). Vulnerabilidad y ética de la investigación social: perspectivas actuales. Revista Latinoamericana de Bioética, 2(29):52-73.

- Seikkula J., y Olson M. (2003). The Open Dialogue Approach to Acute Psychosis: Its Poetics and Micropolitics. Family Process, 42.3:403–18.

- Ten Have H. (2014). The Principle of Vulnerability in the UNESCO Declaration on Bioethics and Human Rights. En Tham J, García A, Miranda G (Eds). Religious Perspectives on Human Vulnerability in Bioethics. Springer, 15-28.

- Vuckovich P, y Artinian B. (2005). Justifying coercion. Nurs Ethics,12(4): 370–380.

- Waldow V, y Borges R. (2008). El proceso de cuidar según la perspectiva de la vulnerabilidad. Revista Latinoamericana Enfermagem, 16(4):765-771.

- Zinkler M. (2016). Germany without Coercive Treatment in Psychiatry—A 15 Month Real World Experience. Laws, 5.15:1–6.