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Journal of Medical Ethics 2005;31:452-456; doi:10.1136/jme.2003.006999
Copyright © 2005 by the BMJ Publishing Group Ltd & Institute of Medical Ethics.

GLOBAL MEDICAL ETHICS

Ethical dilemmas in community mental health care

A Liégeois1 and C Van Audenhove2

1 Faculty of Theology, Catholic University of Leuven, Leuven, Belgium
2 Faculty of Medicine, Catholic University of Leuven, Belgium, Kapucijnenvoer 35, B-3000 Leuven; chantal.vanaudenhove{at}med.kuleuven.ac.be

Correspondence to:
Correspondence to:
Professor A Liégeois
Faculty of Theology, Catholic University of Leuven, Belgium, Sint-Michielsstraat 6, B-3000 Leuven, Belgium; axel.liegeois{at}theo.kuleuven.ac.be

ABSTRACT

Ethical dilemmas in community mental health care is the focus of this article. The dilemmas are derived from a discussion of the results of a qualitative research project that took place in five countries of the European Union. The different stakeholders are confronted with the following dilemmas: community care versus hospital care (clients); a life with care versus a life without care (informal carers); stimulation of the client toward greater responsibility versus protection against such responsibility (professionals); budgetary control versus financial incentives (policy makers), and respect for the client versus particular private needs (neighbourhood residents). These dilemmas are interpreted against the background of a value based ethical model. This model offers an integral approach to the dilemmas and can be used to determine policy. The dilemmas are discussed here as the result of conflicting values—namely autonomy and privacy, support and safety, justice and participation, and trust and solidarity.

Keywords: Community care; deinstitutionalisation; ethical dilemmas; mental health care; participation


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This article has been cited by other articles:

  • Liegeois, A, Eneman, M (2008). Ethics of deliberation, consent and coercion in psychiatry. J. Med. Ethics 34: 73-76 [Abstract] [Full Text]  

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