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Biomedical subjects

C G Westrin

Publications and source records attributed to C G Westrin.

At least 19 recordsLinked to original sources
PubMed2000

[Conflicting values in evaluation of psychiatric care--a review].

Greater understanding is needed regarding psychiatric disorders and their causes, as well as the effects of psychiatric care. Ethical issues ought to be discussed in terms of both the choice of questions and to the ways in which data are collected. So far, most evaluations of psychiatric care have focused on medical utility, while issues of autonomy and impartiality are sorely lacking. An important challenge for the future is therefore to support the evolution of the search for knowledge into a multidisciplinary activity in which values concerning autonomy and impartiality are also incorporated.

Commitment of Persons with Psychiatric Disorders↗
PubMed2000

Psychiatric ethics and health services research. Concepts and research strategies.

In a conceptual frame of reference a distinction is made between different aspects of coercion (formal, perceived and evaluated) and different levels of coercion (hospitalization, treatment and other measures). This frame of reference is used to analyse empirical data from interviews of representative samples of 100 formally committed, the 'probands', and 99 voluntarily admitted sex- and age-matched 'controls'. The results demonstrate that there are many different aspects of coercion; thus, discussions about psychiatric coercion should not be restricted to formally registered commitment. The data also indicate the need to survey the different perceptions of the persons involved in the process of care, in order to understand whether and how coercion has been applied. The results also exemplify the need to include, in all assessments of health care, questions of respect for patient autonomy and integrity.

Case-Control Studies↗
PubMed2000

Values and technology assessment in psychiatry.

Economic resources for health care are limited and they should be distributed as fairly and effectively as possible. But the basis for such a distribution is far from clear. What interests are involved? What kind of provision of care is most efficient? How far should the distribution be left to market solutions? What is the proper role of health care politicians and authorities? In technology assessment a promising combination of value premises and empirical knowledge is used in answering such questions. The aim of this introductory article is to explore issues related to values and value conflicts that have implications for technology assessment. Ethical principles are discussed and related to problematic issues in mental health care such as the absence of psychiatry, the abuse of psychiatry, the definition of mental illness, diagnostic activities, treatment decisions, priority setting as well as research and development.

Ethics, Medical↗
PubMed1995

Coercive measures in psychiatric care. Reports and reactions of patients and other people involved.

In ongoing studies of the quality of the mental health services in two Swedish counties, two thirds of the committed versus about one third of the voluntarily admitted patients reported coercive measures during the index period of care. Committed patients reported an equal degree of coercive treatment and restraint, whereas restraint dominated among the voluntarily admitted. The majority of the patients described the coercive measures as implemented by fait accompli; force was reported in 23% of the examples given by the committed patients but never by the voluntarily admitted. The committed patients justified 19% and the voluntarily admitted 38% of the coercive measures reported; the committed patients justified coercive treatment and restraint to about the same extent; the voluntarily admitted patients justified 65% of the examples of restraint but only 20% of the examples of coercive treatment. There was a 70% concordance between the reports of the committed patients and psychiatric personnel as to the occurrence of coercion, but the head nurses tended to state that treatment had been implemented by persuasion in cases where the patients stated that implementation was by coercion.

Adolescent↗
PubMed1994

The ethics of data utilisation: a comparison between epidemiology and journalism.

Legal controls over data collection in European countries have badly affected the work of epidemiologists. By contrast, journalists have been allowed far greater freedoms. The aims and tasks of both professions are in line with accepted values in our society--especially those of inquiry and the benefits of an open society. Society seems willing to accept that, in the interests of wider public good, journalism may sometimes invade individuals' privacy and do them harm, but it is not prepared to offer epidemiology an equal measure of tolerance.

Biomedical Research↗
PubMed1992

Epidemiology and moral philosophy.

To an increasing extent ethical controversies affect and sometimes obstruct public health work and epidemiological research. In order to improve communication between the concerned parties a model for identification and analysis of ethical conflicts in individual-based research has been worked out in co-operation between epidemiologists and moral philosophers. The model has two dimensions. One dimension specifies relevant ethical principles (as beneficence, non-maleficence, autonomy and justice). The other dimension specifies the groups of persons involved in the conflict under consideration (for example: the study-population, individuals who may benefit from the results, the researchers and their personnel, the community at large). The model has been applied to the problem of legitimacy of case-register research and to problems in psychiatric health services research as well as epidemiological research.

Autopsy↗
PubMed1991

Strategies implemented but goals not attained. Some comments on an evaluation of the Swedish mental health services.

Is the development of Swedish psychiatry a success or not? Available information allows different answers to this question. Valid knowledge would demand psychiatric health service research on a much larger scale and with considerably higher ambitions than hitherto. Strong arguments can be raised about the need for such research to avoid that psychiatry will remain a medical wasteland in which confused policy makers will allocate less interest and money than ever.

Health Plan Implementation↗
PubMed1991

Longitudinal studies on environmental factors and disease. A model for analysis of ethical conflicts.

The use of individual-based data in research has recently come in for much discussion. The basic issue of the discussion is how to balance between different legitimate interests: the interest in improving knowledge on matters important to human health and the interest in respecting individual autonomy. In this paper we will use a model for description and analysis of ethical conflicts in individual-based research. The model consists of two dimensions: the first specifies the persons involved in the conflict, the second specifies the relevant ethical principles. We have chosen the case of the Rönnskär study as an example. For illustration we distinguish between: no study, a study without informed consent and a study with informed consent. In the Rönnskär study the decision between the three situations rests upon an assessment of the conflict between two obligations: to improve the working environment and to respect autonomy.

Conflict, Psychological↗