Oral Presentations Abstracts: OPPORTUNITIES AND RISKS OF SELF-BINDING DIRECTIVES: RESULTS FROM INTERVIEW STUDIES WITH STAKEHOLDERS IN GERMANY AND THE NETHERLANDS

Matthé SCHOLTEN; Laura VAN MELLE; Jakov GATHER; Yolande VOSKES; Guy WIDDERSHOVEN; Jochen VOLLMANN

doi:10.24193/subbbioethica.2021.spiss.108

Authors

Matthé SCHOLTEN Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum Germany. E-mail: matthe.scholten@rub.de
Laura VAN MELLE Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum Germany; Department of Medical Humanities, Department of Medical Humanities, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands
Jakov GATHER Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Germany; Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Germany
Yolande VOSKES Department of Medical Humanities, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands
Guy WIDDERSHOVEN Department of Medical Humanities, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands
Jochen VOLLMANN Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Germany

DOI:

https://doi.org/10.24193/subbbioethica.2021.spiss.108

Abstract

View of Volume 66, Special Issue, September 2021

Self-binding directives (SBDs) are a special type of psychiatric advance directive in which service users agree in advance to (coercive) treatment they might late refuse during a mental health crisis. SBDs aim to empower and protect service users by enabling them to state their values and to plan their (coercive) treatment in advance in consultation with the treating psychiatrist. SBDs have been widely discussed in the ethics literature. Topics include ethical issues surrounding competence, revocation and the ethical justification of involuntary commitment and treatment based on SBDs. Little empirical research on SBDs has been conducted thus far. The Netherlands is to the best of our knowledge the only country with explicit legal provisions for SBDs. On the 1st of January 2020, the new Dutch Law on Compulsory Mental Health Care (Wvggz) entered into force. The implications of this law for the use of SBDs are still unclear.

In this presentation, we will present insights from a qualitative interview study on stakeholders’ experiences with SBDs under the new law and their views on the ethical opportunities and challenges of SBDs. Based on the results, we give recommendations for the implementation of SBDs in other European countries.