임상에서 정신건강의학과 의료윤리의 실제 = Practice of Psychiatry Ethics in the Clinical Applications

국문 초록 (Abstract)

의료윤리의 한 분야인 정신의학윤리는 강제치료와 같은 정신의학의 특성 때문에 복잡한 윤리적 갈등을 나타낼 수 있다. 저자는 정신의학윤리를 포함하고 있는 의료윤리의 기본적인 4원칙에 대해서 기술하고, 정신건강의학과 임상에서 흔히 접하게 되는 여러 가지 윤리적 상황에 대해서 임상사례와 함께 그에 대한 이론을 정리하였다. 의료윤리의 4원칙은 자율성 존중의 원칙, 악행금지의 원칙, 온정적 간섭주의를 포함한 선행의 원칙, 그리고 정의의 원칙이다. 정신건강의학과의 임상상황으로는 억제와 격리시행에 따른 윤리적 문제, 강제입원에 대한 윤리적 문제, 비밀보장의 문제, 자율성과 타인의 이익 문제, 대리결정의 문제, 정신과 환자의 진단문제, 정신과 환자 간의 이성문제, 동의의 문제 등을 기술하였다.

다국어 초록 (Multilingual Abstract)

Psychiatric ethics, which is a field of medical ethics, could show complicated ethical conflicts due to the characteristics of psychiatry such as involuntary treatment. The author described the four basic principles of medical ethics including psychiatric ethics, and organized the clinical cases and theories of various ethical situations that are common in the clinical applications of psychiatry. The four principles of medical ethics are the principle of respect for autonomy, the principle of non-maleficence, the principle of beneficence including paternalism, and the principle of justice. The clinical situations of psychiatry described in this study include ethical problems relevant to restraint and isolation, ethical problems relevant to involuntary hospitalization, confidentiality problem, problems relevant to autonomy and others' benefit, surrogate decision making problem, problems relevant to the diagnosis of psychiatric patients, problems relevant to the relationships with the opposite sex between psychiatric patients, and agreement problem.

참고문헌 (Reference)

1 민성길, "최신정신의학" 일조각 2006

2 문승연, "정신장애인의 결혼생활에 관한 탐색적 연구" 이화여자대학교 사회복지대학원 2002

3 전우택, "정신의학과 윤리" 32 (32): 14-27, 1993

4 서일석, "정신분열증 환자의 결혼생활에 대한 고찰" 20 (20): 451-458, 1981

5 조민정, "정신과 병동 간호사가 인식하는 윤리 문제에 대한 사례 분석 : 원칙주의를 중심으로" 이화여자대학교 대학원 2005

6 손명세, "전공의를 위한 의료윤리: 사례와 해설" 군자출판사 2011

7 박석건, "의료문제의 윤리적 성찰" 단국대학교 출판부 2001

8 한국의료윤리학회, "의과대학 학습목표에 기초한 의료윤리학" 계축문화사 2001

9 Waithe M, "Why Mill was for paternalism" 6 (6): 101-111, 1983

10 Monahan J, "Violence and Mental Disorder: Developments in Risk Assessment" University of Chicago Press 1994

11 Mill J, "Utilitarianism, Liberty, Representative Government" JM Dent and Sons 1968

12 Moss RJ, "The ethics of mechanical restraints" 21 (21): 22-25, 1991

13 Munetz M, "The ethics of mandatory community treatment" 31 (31): 173-183, 2003

14 Chadwick R, "The Philosophy of Psychiatry" Oxford University Press 282-295, 2004

15 Ross W, "The Foundation of Ethics" Clarendon Press 1939

16 Busch AB, "Seclusion and restraint : a review of recent literature" 8 (8): 261-270, 2000

17 Fisher WA, "Restraint and seclusion: a review of the literature" 151 (151): 1584-1591, 1994

18 Greenberg D, "Psychiatry and Ethics" Prometheus 283-298, 1982

19 7)Radden J, "Psychiatric ethics" 16 (16): 397-411, 2002

20 Appelbaum PS, "Privacy in psychiatric treatment : threats and responses" 159 (159): 1809-1818, 2002

21 American Psychiatric Association, "Principles of Medical Ethics: With Annotations Especially Applicable to Psychiatry" American Psychiatric Association 2001

22 Fulford K, "Principles of Health Care Ethics" John Wiley and Sons 681-695, 1994

23 Beauchamp TL, "Principle of Biomedical Ethics" Oxford University Press 1994

24 Wexler D, "Patients, therapist, and third parties: the victimological virtues of Tarasoff" 2 (2): 1-28, 1979

25 Radden J, "Notes towards a professional ethics for psychiatry" 36 : 52-59, 2002

26 Kozub ML, "Least to most restrictive interventions. A continuum for mental health care facilities" 39 (39): 32-38, 2001

27 Chodoff P, "Involuntary hospitalization of the mentally ill as a moral issue" 141 (141): 384-389, 1984

28 Kant I, "Grounding for the Metaphysics of Morals" Hackett 1983

29 Taxis JC, "Ethics and praxis: alternative strategies to physical restraint and seclusion in a psychiatric setting" 23 (23): 157-170, 2002

30 Dyer A, "Ethics and Psychiatry: Toward a Professional Definition" American Psychiatric Press 1988

31 Reich WT, "Encyclopedia Bioethic" Macmillan 2004

32 Gabbard G, "Disguise or consent" 81 (81): 1071-1086, 2000

33 American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders" American Psychiatric Association 2013