Abstract
Free full text
Advance directives in psychiatric care: a narrative approach
Abstract
Advance directives for psychiatric care are the subject of debate in a number of Western societies. By using psychiatric advance directives (or so-called "Ulysses contracts"), it would be possible for mentally ill persons who are competent and with their disease in remission, and who want timely intervention in case of future mental crisis, to give prior authorisation to treatment at a later time when they are incompetent, have become non-compliant, and are refusing care. Thus the devastating consequences of recurrent psychosis could be minimised.
Ulysses contracts raise a number of ethical questions. In this article the central issues of concern and debate are discussed from a narrative perspective. Ulysses contracts are viewed as elements of an ongoing narrative in which patient and doctor try to make sense of and get a hold on the recurrent crises inherent in the patient's psychiatric condition.
Key Words: Medical ethics • narrative ethics • advance directives • psychiatry
Full Text
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Appelbaum PS. Advance directives for psychiatric treatment. Hosp Community Psychiatry. 1991 Oct;42(10):983–984. [Abstract] [Google Scholar]
- Srebnik DS, La Fond JQ. Advance directives for mental health treatment. Psychiatr Serv. 1999 Jul;50(7):919–925. [Abstract] [Google Scholar]
- Dresser Rebecca S. Ulysses and the psychiatrists: a legal and policy analysis of the voluntary commitment contract. Harv Civ Rights-Civil Lib Law Rev. 1982 Winter;16(3):777–854. [Abstract] [Google Scholar]
- Rosenson MK, Kasten AM. Another view of autonomy: arranging for consent in advance. Schizophr Bull. 1991;17(1):1–7. [Abstract] [Google Scholar]
- Swanson JW, Tepper MC, Backlar P, Swartz MS. Psychiatric advance directives: an alternative to coercive treatment? Psychiatry. 2000 Summer;63(2):160–172. [Abstract] [Google Scholar]
- Lavin Michael. Ulysses contracts. J Appl Philos. 1986 Mar;3(1):89–101. [Abstract] [Google Scholar]
- Gert B, Clouser KD. Rationality in medicine: an explication. J Med Philos. 1986 May;11(2):185–205. [Abstract] [Google Scholar]
- Dresser RS, Robertson JA. Quality of life and non-treatment decisions for incompetent patients: a critique of the orthodox approach. Law Med Health Care. 1989 Fall;17(3):234–244. [Abstract] [Google Scholar]
- Berghmans RL. Ethical hazards of the substituted judgement test in decision making concerning the end of life of dementia patients. Int J Geriatr Psychiatry. 1997 Mar;12(3):283–287. [Abstract] [Google Scholar]
- Berghmans R. Advance directives and dementia. Ann N Y Acad Sci. 2000 Sep;913:105–110. [Abstract] [Google Scholar]
- Buchanan Allen. Advance directives and the personal identity problem. Philos Public Aff. 1988 Fall;17(4):277–302. [Abstract] [Google Scholar]
- Radden Jennifer. Choosing to refuse: patients' rights and psychotropic medication. Bioethics. 1988 Apr;2(2):83–102. [Abstract] [Google Scholar]
- Rogers JA, Centifanti JB. Beyond "self-paternalism": response to Rosenson and Kasten. Schizophr Bull. 1991;17(1):9–14. [Abstract] [Google Scholar]
Articles from Journal of Medical Ethics are provided here courtesy of BMJ Publishing Group
Full text links
Read article at publisher's site: https://doi.org/10.1136/jme.27.2.92
Read article for free, from open access legal sources, via Unpaywall: https://jme.bmj.com/content/medethics/27/2/92.full.pdf
Citations & impact
Impact metrics
Article citations
Opportunities and challenges of self-binding directives: A comparison of empirical research with stakeholders in three European countries.
Eur Psychiatry, 66(1):e48, 09 Jun 2023
Cited by: 0 articles | PMID: 37293987 | PMCID: PMC10305757
Opportunities and challenges of self-binding directives: an interview study with mental health service users and professionals in the Netherlands.
BMC Med Ethics, 24(1):38, 03 Jun 2023
Cited by: 1 article | PMID: 37270612 | PMCID: PMC10239595
Opportunities and risks of self-binding directives: A qualitative study involving stakeholders and researchers in Germany.
Front Psychiatry, 13:974132, 21 Oct 2022
Cited by: 4 articles | PMID: 36339872 | PMCID: PMC9633858
Stakeholder perspective on barrier to the implementation of Advance Care Planning in a traditionally paternalistic healthcare system.
PLoS One, 15(11):e0242085, 10 Nov 2020
Cited by: 1 article | PMID: 33170875 | PMCID: PMC7654826
Psychiatric advance directives for people living with schizophrenia, bipolar I disorders, or schizoaffective disorders: Study protocol for a randomized controlled trial - DAiP study.
BMC Psychiatry, 19(1):422, 27 Dec 2019
Cited by: 2 articles | PMID: 31881954 | PMCID: PMC6935101
Go to all (17) article citations
Similar Articles
To arrive at the top five similar articles we use a word-weighted algorithm to compare words from the Title and Abstract of each citation.
A proposal for the use of advance directives in the treatment of incompetent mentally ill persons.
Bioethics, 7(2-3):247-256, 01 Apr 1993
Cited by: 9 articles | PMID: 11651538
[Ulysses contract in psychiatry].
Riv Psichiatr, 52(6):220-225, 01 Nov 2017
Cited by: 2 articles | PMID: 29343871
Review
Protecting autonomy as authenticity using Ulysses contracts.
J Med Philos, 30(4):395-409, 01 Aug 2005
Cited by: 8 articles | PMID: 16029989
Review
Bound to freedom: the Ulysses contract and the psychiatric will.
Univ Tor Fac Law Rev, 45(1):37-68, 01 Jan 1987
Cited by: 4 articles | PMID: 11659143