Ethics in child and adolescent psychiatric care: An international perspective

Abstract

In the treatment of children with psychiatric disorders as a vulnerable population, ethical issues arise that seldom come into play with adults. The UN Conventions on the Rights of the Child and the Rights of Persons with Disabilities set out rights to be respected in child and adolescent psychiatric treatment. Rights of participation and inclusion (minimizing of barriers to the involvement of disabled people) can create complex problems in cases of restraint or deprivation of liberty. This paper analyses the consequences of these conventions and other ethics guidelines on child and adolescent psychiatric treatment and research. Beneficence, justice and autonomy are core principles that are mirrored in the problems of inclusion and protection, confidentiality, and the safety of psychopharmacological interventions. Factors of inclusion are involved in the areas of availability of care, participation in best evidence-based treatment, and research. The right of the child to protection, the right of inclusion, and parents' rights and duties to safeguard their child's wellbeing form a triangle. National laws to regulate the treatment of psychiatrically ill children should be created and implemented and these should be non-discriminatory but at the same time safeguard the developing human being.

Drug development in pediatric psychiatry: current status, future trends

“…But still the number needed to prevent could be studied in the context of a trial, only as McGorry notes if the risk-balance equation is in the proper direction [67]. At the moment there is no legal framework for such a type of preventive intervention and there is relatively little ethical debate about these issues [68]. In child and adolescent psychiatry the recent debate on early preventive interventions in the prodromal phase of schizophrenia might serve as an example [69].…”

Guidance in Social and Ethical Issues Related to Clinical, Diagnostic Care and Novel Therapies for Hereditary Neuromuscular Rare Diseases: “Translating“ the Translational

“…Furthermore, trials can produce large amounts of data, which takes time to collate and analyse. The challenge of analysis can also be complicated by the fact that many participants in RD trials are children affected with chronic diseases, which increases the complexity of interpreting the outcome 21 22 .…”

Prävention – Herausforderungen an eine Entwicklungspsychiatrie

“…pdf) könnte hier interdisziplinäre Forschung bei indizierter Prävention und Frühintervention schwerer entwicklungsneuropsychiatrischer Störungen fördern. Bei der Umsetzung von Studien am Mensch, bei Fragen der Aufklärung/ Einwilligung ist dann wieder stark die altersspezifische Kompetenz gefragt, da Kinder und Jugendliche in der klinischen Forschung einen besonderen Schutz genießen und die Eltern häufig als "Surrogat Decision Maker" speziell informiert werden müssen, wobei nach europäischem Recht die Zustimmung, ohne rechtlichen Einwilligungscharakter der Kinder und Jugendlichen, dennoch von Bedeutung ist (17,18).…”