Ethical Issues in Prison Psychiatry in România

Abstract

AbstractForensic psychiatry is required to adhere to the same ethics, rules, and principles found in general medicine. Overall, România’s legislation respects the international mandates of the United Nations and the World Health Organization and European Union concerning the protection of the mentally ill. The protection of Human Rights and the dignity of persons with mental disorders have to be effective everywhere they are even in the prison or jail, warranting the medical care and the adequate treatment and the social, professional and familial rehabilitation. Society is equally interested in maintaining the autonomy and well-being of its citizens as well as protecting them from risks and dangers caused by their mental disorders. All psychiatrists are faced with situations where compulsive interventions are required to safeguard the patients and those surrounding them. Psychiatrists are involved in the care of mentally ill prisoners, those found guilty and those found not guilty by reason of insanity. In addition, the psychiatrist faces challenging professional, ethical and legal issues in regard to caring for the person with mental illness. In România there are a lack of specialized institutions for patients with co-morbid mental disorders and highly dangerous behavior. Patients suffering from a serious mental illness who are considered a high risk to the community are usually treated in a medium-security forensic psychiatric hospital. There are four such forensic hospitals in România. Individuals considered to be a high risk to the community are hospitalised in Jilava Prison, the only high-security forensic psychiatric hospital in România. There have been some improvements in the quality of care delivered in the mental health services (including the forensic psychiatric hospitals) in România since the implementation of the Mental Health Law 2002. Debate about various ethical issues in this specialized field of mental health continues, such as that of limited confidentiality and the patient’s needs versus societal needs and expectations. The psychiatrist can be between what may be legally right and what may be ethically right.KeywordsMental Health ServicePsychiatric HospitalForensic PsychiatryInvoluntary TreatmentCommunity Treatment OrderThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.