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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Rising to the human rights challenge in compulsory treatment - New approaches to mental health law in Australia
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Rising to the human rights challenge in compulsory treatment - New approaches to mental health law in Australia

机译：强制性待遇的人权挑战 - 澳大利亚精神卫生法的新方法

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Objective: To analyse, and explain to Australasian psychiatrists, recent proposed changes to the terms of coercive treatment for mental illness in Tasmania and Victoria and to place the proposals in the context of a broader human rights framework that is likely to impact the future shape of mental health legislation more generally. Methods: The Australian law reform proposals are reviewed against the requirements of numerous human rights instruments, including the recently ratified United Nations Convention on the Rights of Persons with Disabilities. Ethical and legal arguments are made to support the proposed changes and to introduce others, taking into account academic commentary on mental health law and recent empirical work on the ability to usefully categorise patients by their likelihood of harm to self and others. Results: The Victorian and Tasmanian draft mental health bills propose a new basis for compulsory psychiatric treatment in Australasia. If they become law, coercive psychiatric treatment could only be applied to patients who lack decision-making capacity. The Tasmanian draft bill also sets a new benchmark for timely independent review of compulsory treatment. However both jurisdictions propose to retain an 'additional harm' test which must be satisfied before patients may be treated without consent. This differs from non-psychiatric cases, where if patients are unable to consent to medical treatment for themselves, they will be entitled to receive coercive treatment if it is in their best interests. Conclusions: The proposed changes under the Tasmanian and Victorian draft mental health bills will ensure that, in line with local and international human rights obligations, only patients who lack decision-making capacity may be coercively treated for mental illness. However the continuing 'additional harm' criteria may breach human rights obligations by imposing a discriminatory threshold for care on patients who are unable to consent to treatment for themselves. This could be avoided by replacing the 'additional harm' test with a 'best interests' test.
机译：目的：分析和向澳大利亚精神病学家解释，最近提出的塔斯马尼亚州和维多利亚精神疾病治疗条款的变化，并在更广泛的人权框架中将提案放在可能影响未来形状的范围内心理健康立法更普遍。方法：审查澳大利亚法律改革提案，以审查众多人权文书的要求，包括最近批准的“联合国残疾人权利公约”。道德和法律论据是支持拟议的变革，并介绍其他人，考虑到精神卫生法的学术评论和最近的实证工作，以便通过对自我和他人的可能性造成伤害的可能性来利用患者的能力。结果：维多利亚时代和塔斯马尼亚精神卫生条例草案提出了澳大利亚强制性精神治疗的新基础。如果他们成为法律，胁迫性精神科治疗只能适用于缺乏决策能力的患者。塔斯马尼亚草案法案还设定了一个新的基准，以及时独立审查强制性审查。然而，这两个司法管辖区都建议保留“额外的伤害”测试，在未经同意的情况下可能会在患者进行处理之前必须满足。这与非精神病案件不同，如果患者无法同意自己的医疗，他们将有权获得胁迫治疗，如果它符合其最佳利益。结论：塔斯马尼亚和维多利亚时代的心理卫生法案下的拟议变革将确保符合当地和国际人权义务，只有缺乏决策能力的患者可以为精神疾病治疗。然而，持续的“额外伤害”标准可以通过对无法同意自己治疗的患者施加歧视性门槛来违反人权义务。通过用“最佳利益”测试来替换“额外伤害”测试，可以避免这种情况。

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