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[Ulysses contract in psychiatry]
Andrea Daverio1, Gioia Piazzi2, Anna Saya2
1Istituto Italiano di Igiene Mentale Transculturale, Roma.
Rivista Di Psichiatria
|January 19, 2018
Summary
Psychiatric advance directives allow patients to outline treatment preferences when unable to consent. This review examines the clinical, ethical, and legal complexities of these "Ulysses contracts" for individuals with severe psychiatric disorders.
Area of Science:
- Psychiatry
- Bioethics
- Medical Law
Background:
- Growing focus on patient rights and informed consent in healthcare.
- Evolving therapeutic relationships and patient autonomy.
- Need for advance directives in psychiatric care.
Purpose of the Study:
- Critically review the concept of "Ulysses contracts" or psychiatric advance directives.
- Analyze the complexities from clinical, ethical, legal, and psychodynamic perspectives.
- Evaluate the strengths and criticisms of psychiatric advance directives.
Main Methods:
- Literature review of psychiatric advance directives.
- Analysis of existing ethical, legal, and clinical frameworks.
- Exploration of psychodynamic implications.
Main Results:
- Psychiatric advance directives address patient wishes for treatment when consent is impossible.
- Complexities arise regarding patient capacity and caregiver instructions during intercritical periods.
- Strengths and criticisms exist across clinical, ethical, legal, and psychodynamic domains.
Conclusions:
- Psychiatric advance directives are a significant development in patient rights for those with severe mental illness.
- Interdisciplinary considerations are crucial for effective implementation.
- Further debate is needed to refine their application and address criticisms.
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