Ethics in child and adolescent psychiatric care: An international perspective.
In the treatment of children with psychiatric disorders as a vulnerable population, ethical issues arise that seldom come into play with adults. The UN Conventions on the Rights of the Child and the Rights of Persons with Disabilities set out rights to be respected in child and adolescent psychiatric treatment. Rights of participation and inclusion (minimizing of barriers to the involvement of disabled people) can create complex problems in cases of restraint or deprivation of liberty. This paper analyses the consequences of these conventions and other ethics guidelines on child and adolescent psychiatric treatment and research. Beneficence, justice and autonomy are core principles that are mirrored in the problems of inclusion and protection, confidentiality, and the safety of psychopharmacological interventions. Factors of inclusion are involved in the areas of availability of care, participation in best evidence-based treatment, and research. The right of the child to protection, the right of inclusion, and parents' rights and duties to safeguard their child's wellbeing form a triangle. National laws to regulate the treatment of psychiatrically ill children should be created and implemented and these should be non-discriminatory but at the same time safeguard the developing human being.
Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Ulm, Germany. michael.koelch@uniklinik-ulm.de <michael.koelch@uniklinik-ulm.de>
Michael
M
Koelch
Joerg M
JM
Fegert
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004995:Ethics, Professional; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D007391:International Cooperation; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000941:ethics / Q000458:organization & administration*; D011570:Psychiatry / Q000941:ethics*; D014480:United Nations; D035862:Vulnerable Populations