Psychiatry and human rights in Latin America: Ethical dilemmas and the future

Abstract

This paper addresses the context in which ethical and human right issues as they pertain to psychiatry are discussed in Latin America. Dependency and institutional instability are singled out as pervading characteristics influencing the analysis of issues and the design of mental health policies. According to the landmark 1990 Declaration of Caracas all countries in the region have progressed towards implementing measures designed to improve the condition of the populations regarding mental health care and research. Several principles are now universally accepted and, while there is still room for improvement, provision of services and better contexts for scientific development make it possible to expect advances in the future.

Mental health and psychiatry: Distinctions, links, and ethical/bioethical perspectives

“…In the strictly clinical field, these changes affect both patients and the society of which they are part. No longer characterized merely by passivity, dependence, suffering, or frustrations of different kinds, patients are gradually becoming activists in defense of inalienable rights (Lolas 2010b;de la Fuente Muñiz, 2021). It is in the face of this "patient emancipation" process (Montori, 2020) that ethics must confer balance and discretion on the organizations involved.…”

Princípio bioético da autonomia na atenção à saúde indígena

“…Nas práticas assistenciais, preza-se pela difusão do conhecimento de forma a tornar os indígenas mais esclarecidos e empoderados sobre o processo nosológico ou simplesmente busca-se impor o ponto de vista biomédico e reducionista? Diante dessa polêmica, há quase duas décadas, Lolas 23 comentava que os países latino-americanos tinham características culturais e institucionais que impunham reorganizar e adequar o campo da bioética, visando um enfoque que valorizasse mais as práticas religiosas, comunitárias e os saberes da medicina tradicional ancestral dos povos indígenas, aceitando-as como complementariedade terapêutica, incluindo seus rituais e o uso de plantas que lhe são típicos, integrando esses elementos às práticas da medicina ocidental. Torna-se necessário perguntar: "proteger a autonomia de quem?…”

The bioethical principle of autonomy in caring for the health of Indigenous peoples

“…In health care practices, is the dissemination of knowledge valued to make Indigenous people more enlightened and empowered about the disease process or is it simply seeking to impose a biomedical and reductionist point of view? Faced with this polemic, almost two decades ago, Lolas 23 commented that Latin American countries had cultural and institutional characteristics which made it necessary to reorganize and adapt bioethics, aiming at an approach which would give more value to Indigenous peoples' religious, communal, and ancestral traditional medicine practices. Such practices should be accepted as therapeutically complementary, including their rituals and the use of plants that are typical to them, in addition to integrating such elements into the practices of Western medicine.…”