Biomedical subjects

F Weil

Publications and source records attributed to F Weil.

18 recordsLinked to original sources

PubMed1993

The right of the mental patient to be medically informed.

Parallel to changes in the nature of the relationship between the physician and his or her patient, have been shifts in the mode of transmission of information to the patient concerning his or her illness. Historically, the therapist-patient bond was based on a complementarity of status: For the patient, ignorance and anxiety drew him or her to seek the help of a therapist for whom rationality and scientific knowledge were the basis of his or her response. In the more recent past, the patient's active involvement in the therapeutic process has been intensified. Medical paternalism has been progressively rejected. Treatment could thus be initiated only after informed consent was given, in the context of verbal transmission of information by the therapist to the patient and the patient's right to consult 'his or her own' medical records evolved. This article details the risks of such a right--especially in psychiatry--for the patient himself or herself, for the collateral sources who have transmitted confidential information to the therapist, and for the therapist-patient relationship.

Europe↗

PubMed1993

Ethical and moral dilemmas in the treatment of an abusive parent--the occupational therapy perspective.

Treating patients who physically abuse their children creates in the therapist moral and ethical dilemmas which challenge his or her ability to maintain a professional conduct and attitude. In such cases the therapist usually finds himself or herself confronted with the following dilemmas: (a) treatment of a patient who experiences therapy as a no-choice situation; (b) treatment of a patient whose conduct is in conflict with the moral values of the therapist; (c) the obligation of the therapist to report the abusive acts to the authorities versus his or her duty to protect the patient's right to confidentiality; and (d) the therapist's loyalty to the patient's welfare, when it is in conflict with the abused person's welfare. These issues are illustrated through the following case study examined in the context of occupational therapy (OT): A 26-year-old married woman, mother to a four-month-old infant was referred to therapy after causing severe burns to her daughter's hands. As a child the patient experienced physical abuse by her parents. The patient viewed treatment as her only possible means of keeping her child. On the other hand, she was suspicious of verbal therapy, as she assumed that the contents might incriminate her. Occupational therapy was therefore a major therapeutic modality used to assess and improve her disturbed psychosocial occupational performances. The article describes the way in which the OT approach helped overcome and resolve the moral and ethical dilemmas raised in the case.

Adult↗

PubMed1993

Releasing the treating psychiatrist from confidentiality.

Confidentiality is one of the oldest and most universal traditions of medicine. This rule is beneficial to the patient, who can disclose his or her secrets to his or her therapist without reluctance, to the physician, who enjoys a privileged relationships with his or her patient and to society at large, interested in public health and unrestricted access of all citizens to treatment. Nevertheless, each one of these beneficiaries claims the right to break this rule. The patient considers that the confidence is his or hers and may be disposed of at his or her discretion. The psychiatrist claims that he or she cannot remain silent and passive when the absence or delay of treatment of a reluctant patient can result in a disaster. Finally, society advocates the existence of a hierarchy which places the protection of society above the interests of the individual. Originally, breaches in confidentiality allowed by the legislator were chiefly intended to enable the patient to enjoy his or her rights or to facilitate treatment. Moreover the physician was encouraged to limit released data to those which were necessary for the purpose stated in the request for information. Unfortunately, the extent of the breaches is increasing. Some of the exceptions, like the obligation to report child abuse or imminent danger to others (Tarasoff) are usually readily accepted. This article details cases which give concern inasmuch as the disclosure of information exposes the patient to diverse restrictions. For example the right to confidence is waived by the patient under external pressure as a condition to obtain employment, access to military service or a driver's licence.(ABSTRACT TRUNCATED AT 250 WORDS)

Commitment of Persons with Psychiatric Disorders↗

PubMed1992

A plea for the establishment of psychiatric forensic units in Israel.

The growing interaction between psychiatric and legal systems justifies the establishment of specialized services. From a theoretical viewpoint, the obligation of judges to apply a dichotomic categorization between 'mentally ill' offenders and the rest--encompassing a wide spectrum of normal people as well as those suffering from severe personality disorders--contradicts the psychiatrist's conception of continuum in pathology and liability. In practice, the criterion of accountability determines whether an offender will be punished or treated in a mental institution. Mentally disturbed but non-psychotic offenders cannot benefit from advances in psychiatric techniques. This article details suggestions for change: The decision about mentally disturbed offenders should be based on two criteria--liability and chance of improvement through treatment. The judicial decision may then integrate punishment and treatment. The establishment of psychiatric forensic units would significantly add to the present range of services handling mentally disturbed offenders, would end the dispersion of the professionals (psychiatrists, psychologists, criminologists, social workers, probation officers) involved in the management of such offenders, and could provide an academic base and a framework for training residents.

Commitment of Persons with Psychiatric Disorders↗

PubMed1989

Irresistible impulse: psychiatric viewpoint.

The responses of the psychiatric profession to the legal criteria applied to irresistible impulse in cases of psychotic offenders are examined. An illustrative case, and its legal consequences, support the desirability of the psychiatric approach.

Attitude to Health↗

PubMed1985