精神卫生服务伦理及法律问题.pptVIP

* * According to these statistics students in schools do not perceive that they are in a safe place. There are indications in these numbers that a great number of students are suffering from anxiety. * Legislation can play an important role in improving access to mental health care. Improving access means increasing availability of services, improving financial and geographical accessibility and providing services that are acceptable and of adequate quality. Legislation can help to improve access by addressing the following issues Mental health financing Integrating mental health with primary care Allocating resources to underserved populations Improving access to medications Improving access to psychosocial interventions Improving access to health insurance Promoting community care and de-institutionalisation * Legislation can play an important role in improving access to mental health care. Improving access means increasing availability of services, improving financial and geographical accessibility and providing services that are acceptable and of adequate quality. Legislation can help to improve access by addressing the following issues Mental health financing Integrating mental health with primary care Allocating resources to underserved populations Improving access to medications Improving access to psychosocial interventions Improving access to health insurance Promoting community care and de-institutionalisation * * * * * * 精神卫生服务的伦理与法律问题 * 内容大纲 精神卫生服务的伦理特点 患者权益保障的要求 产生医患纠纷的主要问题 * 精神卫生服务的伦理特点 * 人类对精神疾病的认识 远古时代：魔鬼附体、冒犯神灵后的惩罚 希波克拉底时代 ：体液不协调 中世纪 ：原罪 文艺复兴时期：神经网络故障（疯人院） 16-17世纪：大禁闭、社会控制（总医院） 18-19世纪：人道主义解放运动 20世纪以后：法律保障 * 精神卫生机构的总体现状 偏见歧视较为普遍 规模较大但设备设施简陋陈旧 封闭式管理、非自愿治疗 服务观念和方式落后 发展动力不足、岗位缺乏吸引力 患者权益缺少有效保障 * 精神科临床工作的特殊性 患者就诊形式 特殊的治疗方法（如ECT） 药物副作用明显 约束隔离 强制治疗 隐私与保密 危险行为 * 患者权益保障的有关要求 * 在精神卫生机构中的权益和条件 指定的专业机构（精神病人） 获得及时、规范的医疗救治 保证私密性和通讯自由 不被强迫劳动，自愿劳动有报酬 独立的医学伦理委员会 * 患者的权益 隐私保护 医疗相关信息未经许可不应泄露给第三方 特定的例外情形 对泄露隐私要加以处罚 获取信息 自由而完整地获取临床信息 特定的例外情形 知情同意 * 知情同意 患者和/或监护