RESUMO
People with mental illness are subjected to stigma and discrimination and constantly face restrictions in the exercise of their political, civil and social rights. Considering this scenario, mental health, ethics and human rights are key approaches to advance the well-being of persons with mental illnesses. The study was conducted to review the scope of the empirical literature available to answer the research question: What evidence is available regarding human rights and ethical issues regarding nursing care to persons with mental illnesses? A scoping review methodology guided by Arksey and O'Malley was used. Studies were identified by conducting electronic searches on CINAHL, PubMed, SCOPUS and Hein databases. Of 312 citations, 26 articles matched the inclusion criteria. The central theme which emerged from the literature was "Ethics and Human Rights Boundaries to Mental Health Nursing practice". Mental health nurses play a key and valuable role in ensuring that their interventions are based on ethical and human rights principles. Mental health nurses seem to have difficulty engaging with the ethical issues in mental health, and generally are dealing with acts of paternalism and with the common justification for those acts. It is important to open a debate regarding possible solutions for this ethical dilemma, with the purpose to enable nurses to function in a way that is morally acceptable to the profession, patients and members of the public. This review may serve as an instrument for healthcare professionals, especially nurses, to reflect about how to fulfil their ethical responsibilities towards persons with mental illnesses, protecting them from discrimination and safeguarding their human rights, respecting their autonomy, and as a value, keeping the individual at the centre of ethical discourse.
Assuntos
Cuidados de Enfermagem , Enfermagem Psiquiátrica , Direitos Humanos , Humanos , Saúde Mental , PaternalismoRESUMO
The challenges and constraints of meaningful engagement with patients are discussed from a standpoint of relational ethics. If openness to others and to their situation is the beginning of ethics, as is argued by philosophers whose work informs relational ethics, then in health care we must address that openness (or its lack) as it is lived by individual health professionals within the immediacy and complexity of their practice. If, as has been also argued, disengagement is the source of maleficence within healthcare systems, addressing constraints to engagement becomes particularly urgent.
Os desafios e restrições da interação significativa com os pacientes são discutidos do ponto de vista da ética relacional. Se a abertura para os outros e sua situação é o início da ética, como argumentado por filósofos cujo trabalho informa a ética relacional, então, no cuidado de saúde, nós devemos lidar com esta abertura (ou sua ausência) assim como vivida pelo indivíduo que é profissional da saúde, dentro das necessidades imediatas e da complexidade de sua prática. Se, como tem sido argumentada, a falta de compromisso é a origem da maleficência nos sistemas de saúde, enfrentar limites ao comprometimento das profissionais de saúde se torna particularmente urgente.
En el presente artículo, los desafíos y restricciones del significado de compromiso con los pacientes son discutidos del punto de vista de la ética relacional. Si la abertura a los otros y su situación es el inicio de la ética, tal como es argumentado por los filósofos vinculados con la ética relacional, entonces, nosotros en el cuidado de salud debemos dirigir esta abertura (o su falta) como siendo vivida por un profesional de la salud dentro de la importancia y de la complejidad de la práctica. Como ha sido argumentado, si la falta de compromiso es el origen de la maleficencia en el sistema de cuidado a la salud, es particularmente urgente establecer límites y comprometerse.