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Luciano M, De Rosa C, Sampogna G, Del Vecchio V, Giallonardo V, Fabrazzo M, Catapano F, Onchev G, Raboch J, Mastrogianni A, Solomon Z, Dembinskas A, Nawka P, Kiejna A, Torres-Gonzales F, Kjellin L, Kallert T, Fiorillo A. How to improve clinical practice on forced medication in psychiatric practice: Suggestions from the EUNOMIA European multicentre study. Eur Psychiatry 2018; 54:35-40. [PMID: 30118917 DOI: 10.1016/j.eurpsy.2018.07.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/12/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND The decision to adopt forced medication in psychiatric care is particularly relevant from a clinical and ethical viewpoint. The European Commission has funded the EUNOMIA study in order to develop European recommendations for good clinical practice on coercive measures, including forced medication. METHODS The recommendations on forced medication have been developed in 11 countries with the involvement of national clinical leaders, key-professionals and stakeholders' representatives. The national recommendations have been subsequently summarized into a European shared document. RESULTS Several cross-national differences exist in the use of forced medication. These differences are mainly due to legal and policy making aspects, rather than to clinical situations. In fact, countries agreed that forced medication can be allowed only if the following criteria are present: 1) a therapeutic intervention is urgently needed; 2) the voluntary intake of medications is consistently rejected; 3) the patient is not aware of his/her condition. Patients' dignity, privacy and safety shall be preserved at all times. CONCLUSION The results of our study show the need of developing guidelines on the use of forced medication in psychiatric practice, that should be considered as the last resort and only when other therapeutic option have failed.
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Affiliation(s)
- Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Corrado De Rosa
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Michele Fabrazzo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Francesco Catapano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - George Onchev
- Department of Psychiatry, Medical University Sofia, Sofia, Bulgaria
| | - Jiri Raboch
- Department of Psychiatry, First Faculty of Medicine Charles University and General University Hospital, Prague, Czech Republic
| | | | - Zahava Solomon
- Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel
| | - Algirdas Dembinskas
- Psychiatric Clinic, Vilnius Mental Health Centre, University of Vilnius, Vilnius, Lithuania
| | - Petr Nawka
- Psychiatric private practice, Dresden, Germany
| | - Andrzej Kiejna
- Institute of Psychology, University of Lower Silesia, Wroclaw, Poland
| | | | - Lars Kjellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Thomas Kallert
- Psychiatric Health Care Facilities of Upper Franconia (GEBO), Bayreuth, Germany
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy.
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