Detailed contribution information
| Contribution title | 2995 - Classification of ethical issues in the psychiatric treatment of adolescents |
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| Contribution code | PS01-90 (P) |
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| Form of presentation | Poster |
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| Abstract |
Objectives: The objective of our research project is a much needed classification of ethical issues in the psychiatric treatment, which will help to "diagnose" ethical problems. By ethical issues we mean the mental representation of situations that triggers the reflection of normative expectations. Diagnostic manuals for medical as well as for psychiatric issues are developed since decades and are meanwhile used by default. Since they facilitate the (interdisciplinary) communication and the initiation of indexed interventions formidably, it seems astonishing that comparable classification systems for ethical issues are still lacking completely. Method: Data were gathered on an adolescent psychiatric, psychotherapy-oriented ward, during weekly rounds and case discussions. An embedded researcher documented – without interfering in any way – the observed ethical issues that were afterwards discussed in depth in the research team. The typical selection bias of case studies was avoided by conducting an exhaustive survey over six months (first half of 2015). In a first step of analysis, data were formally categorized in groups of deciders of ethical decisions already taken or to be taken. In the second step, data were subsequently structured by the ethical characteristics of those decisions. Results: During the period of the data collection 29 patients were treated on the ward (age range 13-18.9 yrs, average 16.6 yrs). The formal categorization of 264 ethically relevant decisions resulted largely in three main categories of deciders: "team", "patient" and "parent". The subsequent structuring led to 24 subordinate categories – 12 sub-categories under the main category "team", six under the main category "patient" and four under the main category "parents". For illustration, the highest prevalence displayed the main category "professional team" and the sub-category "patient’s plan and conduct of life", which included the discussion of recommendations concerning education or career planning, (foster care) placement or e.g. demanding too much or too little of oneself. Conclusion: The first step to a suitable classification was successfully achieved. After its further extension and validation, it shall facilitate interdisciplinary communication and cooperation. It is expected to enable the early and reliable identification of ethical issues in clinical practice as well as their articulation in precise terms opening up the perspective to agree on problem-solving strategies. |