| Abstract | Svaka primjena sile koja se na bilo koji način primjenjuje u terapijskom postupku može predstavljati ozbiljno kršenje etičkih i zakonskih normi. Ponajprije zato što je prisila negativno iskustvo za svako ljudsko biće, i ne samo da se njome krše ljudska prava na slobodan izbor, nego je ona etički gledano, i povreda prava na autonomiju, osobne izbore ili pak utječe da ljudi djeluju ili iskuse nešto što ne žele. Primjena sile u psihijatriji nužna je samo iznimno i u ograničenom trajanju, u situacijama kada se opasnim ponašanjem izravno ugrožava život i zdravlje osobe ili okoline, te se smije primijeniti samo ako za to postoje osnovani i zakonom propisani razlozi.
Pozitivna zakonska regulativa, posebno Zakon o zaštiti osoba s duševnim smetnjama (NN, 76/2014) i Pravilnik o vrstama i načinu primjene mjera prisile prema osobama s težim duševnim smetnjama (NN, 16/2015) dodatno štite prava oboljelih, propisuju vrste i način primjene prisile i procedure za postupanje.
Etičke su se dileme počele promatrati i iz perspektive sestrinske odgovornosti i dužnosti. One se često nalaze u vrlo zahtjevnim situacijama i za određeni moralni izbor ili radnju moraju imati vrlo jake argumente. Sudjelujući u moralnim raspravama ili boreći se za svoja stajališta, svoje mišljenje moraju utemeljiti ili na etičkim pravilima i principima ili na sintezi teorijskog znanja i iskustva.
Propitivanje moralnog ponašanja i djelovanja u donošenju etičkih odluka važno je u djelokrugu rada svih medicinskih sestara, a osobito je težak izazov za one medicinske sestre koje rade u psihijatriji. U tome im pomažu etička pravila i principi, kontinuirana edukacija te smjernice i strategije za postupanje, potrebne u donošenju ispravnih etičkih odluka. |
| Abstract (english) | Each act of force or coercive measure, applied in a therapeutic procedure, may lead to severe violation of professional ethics and legal standards. First and foremost, being forced is a negative experience for any human in any situation; furthermore it is a human rights violation and, in ethical aspects – it is a clear example of violation of patients’ autonomy, violation of patients’ rights to make decisions for themselves, and of forcing them to behave or act in the way that is involuntary. Force in psychiatry is necessary only in exceptional situations and must be timely restricted, in circumstances when patients’ behaviour can be harmful for them or others, and can be applied only if it is legally justified.
Positive legal regulations, Act on the protection of persons with mental disabilities (NN, 76/2014), and Regulation on treatment pressures in health care of patients with severe mental illnesses (NN, 16/2015), additionally protect patients' rights and regularize types and methods of applying enforcement and define procedures.
Various ethical issues have been envisaged, taking in account, nurses’ responsibilities and duties. Nurses are often exposed to challenging circumstances and their professional response has to be supported by strong arguments. If nurses participate in discussions about moral issues and in occasions that they have an opportunity to defend their opinions, nurses must express their opinion relying on ethical rules and principles, and on synthesis of their knowledge and skills.
Permanent questioning of the ethics while making professional decisions is important part of nursing profession, and is of exceptional importance for nurses working at the psychiatric wards. Ethical rules and principles, permanent education, guidelines and procedures strategies are measures that lead to making right, professional and ethical decisions. |
