Protecting Autonomy as Authenticity Using Ulysses Contracts

Willigenburg, Theo van; Delaere, Patrick

doi:10.1080/03605310591008595

Cited by 30 publications

(18 citation statements)

References 11 publications

(10 reference statements)

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“…20 An authentic choice is a choice stemming from these values, while an inauthentic choice goes against them. Autonomy is often referred to as self-governing or sovereignty.…”

Section: Autonomy and Authenticitymentioning

confidence: 99%

Coercive Treatment and Autonomy in Psychiatry

Sjöstrand

Helgesson

2008

Bioethics

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There are three lines of argument in defence of coercive treatment of patients with mental disorders: arguments regarding (1) societal interests to protect others, (2) the patients' own health interests, and (3) patient autonomy. In this paper, we analyse these arguments in relation to an idealized case, where a person with a mental disorder claims not to want medical treatment for religious reasons. We also discuss who should decide what in situations where patients with mental disorders deny treatment on seemingly rational grounds. We conclude that, in principle, coercive treatment cannot be defended for the sake of protecting others. While coercive actions can be acceptable in order to protect close family and others, medical treatment is not justified for such reasons but should be given only in the interest of patients. Coercive treatment may be required in order to promote the patient's health interests, but health interests have to waive if they go against the autonomous interests of the patient. We argue that non-autonomous patients can have reasons, rooted in their deeply-set values, to renounce compulsory institutional treatment, and that such reasons should be respected unless it can be assumed that their new predicaments have caused them to change their views.

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“…20 An authentic choice is a choice stemming from these values, while an inauthentic choice goes against them. Autonomy is often referred to as self-governing or sovereignty.…”

Section: Autonomy and Authenticitymentioning

confidence: 99%

Coercive Treatment and Autonomy in Psychiatry

Sjöstrand

Helgesson

2008

Bioethics

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“…On the other hand, there is the potential compulsion induced by the application of DBS. In regard of the benefit of DBS, the so-called Ulysses contract could be applicable in this case (Van Willigenburg and Delaere 2005;Schöne-Seifert 2007). A patient about to undergo DBS could be interviewed about his wishes in advance so that the Ulysses contract can be written, in which the patient could determine the procedure during the period of stimulation (Talbot 2009).…”

Section: The Influence Of Dbs On the Components Of Autonomous Actionsmentioning

confidence: 97%

The ethics of deep brain stimulation (DBS)

Oduncu

2015

Med Health Care and Philos

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Deep brain stimulation (DBS) is an invasive technique designed to stimulate certain deep brain regions for therapeutic purposes and is currently used mainly in patients with neurodegenerative disorders, such as Parkinson's disease. However, DBS is also used increasingly for other experimental applications, such as the treatment of psychiatric disorders (e.g. severe depression), weight reduction. Apart from its therapeutic potential, DBS can cause severe adverse effects, some that might also have a significant impact on the patient's personality and autonomy by the external stimulation of DBS which effects lie beyond the individual's control and free will. The article's purpose is to outline the procedures of DBS currently used in therapeutic and experimental applications and to discuss the ethical concerns regarding this procedure. It will address the clinical benefit-risk-ratio, the particular ethics of research in this field, and the ethical issues raised by affecting a patient's or an individual's personality and autonomous behaviour. Moreover, a potential ethical guideline, the Ulysses contract is discussed for the field of clinical application as well as the question of responsibility.

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“…La perte d'autonomie est un coût indirect associé à la détérioration du fonctionnement social des patients qui restent longtemps à l'hôpital . Les DPA peuvent potentiellement accroître l'autonomie et atténuer les traumatismes et la peur associés à la perte de la liberté de choix lors d'une crise psychiatrique future (Scheyett et al, 2007 ;Swanson et al, 2003 ;van Willigenburg et Delaere, 2005). La relation entre les DPA et l'autonomie a surtout été expliquée par des arguments philosophiques, moraux et juridiques (Davis, 2008 ;Ritchie et al, 1998).…”

Section: La Valeur De L'autonomieunclassified

Les directives psychiatriques anticipées (DPA) et le rôle de l’autonomie

Crocker

2010

smq

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Tous droits réservés © Santé mentale au Québec, 2009 Ce document est protégé par la loi sur le droit d'auteur. L'utilisation des services d'Érudit (y compris la reproduction) est assujettie à sa politique d'utilisation que vous pouvez consulter en ligne. Résumé de l'article Bien que les directives psychiatriques anticipées (DPA) soient ancrées dans l'éthique de l'autonomie, le lien entre les deux reste imprécis. Les DPA sont des documents juridiques qui permettent aux personnes qui vivent avec un problème de santé mentale de spécifier leurs préférences de traitement advenant une incapacité future. Le rapport entre l'autonomie et les DPA a été abordé en termes tant légaux et éthiques que philosophiques, mais il n'a pas été clairement opérationnalisé sur le plan clinique. L'autonomie est une valeur éthique fondamentale qui englobe la notion d'indépendance face à des influences contrôlantes externes, ainsi que la capacité mentale de prendre ses propres décisions. Les personnes qui vivent avec un problème de santé mentale ont parfois besoin d'aide pour bien comprendre leurs droits éthiques et juridiques en matière de choix autonome, alors que les intervenants professionnels doivent être mieux formés quant à l'importance de l'autonomie dans leur pratique clinique. La capacité de consentir au traitement est le préalable d'ordre mental qui assure que les personnes ayant des troubles mentaux sont en mesure de rédiger des DPA en toute connaissance de cause, alors que l'autonomie est la valeur qui leur donne le pouvoir de contribuer à leur rétablissement.

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Protecting Autonomy as Authenticity Using Ulysses Contracts

Cited by 30 publications

References 11 publications

Coercive Treatment and Autonomy in Psychiatry

Coercive Treatment and Autonomy in Psychiatry

The ethics of deep brain stimulation (DBS)

Les directives psychiatriques anticipées (DPA) et le rôle de l’autonomie

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