当共同决策崩溃：解决抗精神病药物处方中的道德困境。

IF 2.5 4区医学 Q2 PSYCHIATRY

Harvard Review of Psychiatry Pub Date : 2025-05-01 DOI:10.1097/HRP.0000000000000430

Helene Speyer, Ju Zhang, John Lysaker, David Roe

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引用次数: 0

摘要

摘要：许多被诊断为精神病的个体多次尝试停止抗精神病药物治疗。在这个临床挑战中，我们研究了三个快照，其中共享决策（SDM）由于服务用户和医疗保健提供者之间的持续分歧而中断。我们提供了如何看待这种分歧的三种观点：哲学、心理学和精神病学的观点。最后，我们提出共享审议作为SDM失败时的潜在模型，强调相互价值共享的迭代过程，避免二元是/否响应。

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When Shared Decision-Making Breaks Down: Solving Moral Dilemmas in Antipsychotic Deprescribing.

Abstract: Many individuals diagnosed with psychosis make multiple attempts to discontinue antipsychotic medications. In this clinical challenge, we examine three snapshots in which shared decision-making (SDM) breaks down due to ongoing disagreement between the service user and the health care provider. We offer three perspectives on how to think about such disagreement: philosophical, psychological, and psychiatric perspectives. Finally, we propose shared deliberation as a potential model for when SDM fails, emphasizing an iterative process of mutual value sharing that avoids binary yes/no responses.

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来源期刊

Harvard Review of Psychiatry PSYCHIATRY-

CiteScore

7.50

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： The Harvard Review of Psychiatry is the authoritative source for scholarly reviews and perspectives on important topics in psychiatry. Founded by the Harvard Medical School''s Department of Psychiatry, the Harvard Review of Psychiatry features review papers that summarize and synthesize the key literature in a scholarly and clinically relevant manner. Topics covered include: Schizophrenia and related disorders; Mood disorders; Personality disorders; Substance use disorders; Anxiety; Neuroscience; Psychosocial aspects of psychiatry; Ethics; Psychiatric education; and much more. In addition, a Clinical Challenges section presents a case with discussion from a panel of experts. Brief reviews are presented in topic-specific columns that include Cross-Cultural Psychiatry, History of Psychiatry, Ethics, and others.