Una riflessione sul trattamento sanitario obbligatorio coattivo e sul Codice deontologico

Introduction: In psychiatry informed consent is an uttermost complex topic, especially when considering the 2006 Code of Medical Ethics/Medical Ethics Code (articles 33 and 35). Informed consent is the foundation of every possible therapeutic choice, although there are some notable exceptions, such as compulsory treatment for psychiatric reasons. Materials and methods: The current mental health law system has been evaluated. It is noted that informed consent is not the central issue in the reasons for the involuntary admission. The problem of informed consent is subordinated to an ill-defined medical condition such as "psychic alterations that request an urgent intervention". This ill defined condition leaves a wide array of difficulties open, when the psychiatrist has to propose the compulsory treatment. Results: We consider that the stratification of different laws about freedom/mental illness interface is not rationally harmonized with the centrality of informed consent in medicine. Conclusions: It would be appropriate to develop an evaluation of compulsory admission based on the centrality of informed consent (that is, the lack of informed consent). Consent can be viewed as an initial recovery of responsibility for the patient. © 2010 Elsevier Srl. All rights reserved.