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首页> 美国卫生研究院文献>Frontiers in Psychiatry >Psychiatric Advance Directives Under the Convention on the Rights of Persons With Disabilities: Why Advance Instructions Should Be Able to Override Current Preferences
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Psychiatric Advance Directives Under the Convention on the Rights of Persons With Disabilities: Why Advance Instructions Should Be Able to Override Current Preferences

机译：残疾人权利公约下的精神病学预先指示：为什么预先指示应能取代目前的偏好

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摘要

Psychiatric advance directives (PADs) are documents by means of which mental health service users can make known their preferences regarding treatment in a future mental health crisis. Many states with explicit legal provisions for PADs have ratified the United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD). While important UN bodies consider PADs a useful tool to promote the autonomy of service users, we show that an authoritative interpretation of the CRPD by the Committee on the Rights of Persons with Disabilities has the adverse consequence of rendering PADs ineffective in situations where they could be of most use to service users. Based on two clinical vignettes, we demonstrate that reasonable clinical recommendations can be derived from a more realistic and flexible CRPD model. Concerns remain about the accountability of support persons who give effect to PADs. A model that combines supported decision making with competence assessment is able to address these concerns.
机译：精神病学预先指示（PAD）是文件，通过这些文件，精神卫生服务用户可以了解他们在未来精神卫生危机中对治疗的偏好。许多对PAD都有明确法律规定的州已经批准了《联合国残疾人权利公约》（CRPD）。尽管重要的联合国机构认为PAD是促进服务用户自治的有用工具，但我们表明，残疾人权利委员会对CRPD的权威解释会带来不利后果，使PAD在可能的情况下失效。最常用于服务用户。基于两个临床渐近线，我们证明合理的临床建议可以从更现实，更灵活的CRPD模型中得出。对于实施PAD的支持人员的责任制，仍然存在担忧。将支持的决策与能力评估相结合的模型能够解决这些问题。

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