被收容精神病人治疗中的伦理问题

对于流浪精神病人的收容治疗，医院应当坚持社会效益第一、病人利益至上的原则，按人道主义精神，精心治疗。同时，政府应该在立法上予以重视。社会各界的帮助、公安民政的配合参与，有利于此项工作开展，家属必须善待精神病人。     

L’histoire de la psychiatrie légale à la Société Médico-Psychologique

ObjectivesThis paper seeks to establish the contribution of the discussions of the Société Médico-Psychologique (SMP) to the history of forensic psychiatry in France during the century following its birth in 1852.MethodsWe summarize the discussions held during the Second Empire and the beginning of the Third Republic, about the criminally insane, the dangerously insane, the insane with consciousness and about assistance. Synthesis articles published from the middle of the 20^th century on the law of 1838 (Desruelles), psychiatric forensic medicine (Heuyer), assistance from 1789 to 1838 (Bollotte) and from 1838 to 1939 (Demay), are analyzed.ResultsThe principal themes of forensic psychiatry have been treated in depth at the SMP, in their clinical, juridical and philosophical aspects. The paper contains three chapters: (1) dangerous lunatics: the association between insanity and criminality, the responsibility of delinquent insane persons, the criteria of dangerous behavior in “reasoning” lunatics and in lunatics with consciousness; (2) inpatient and outpatient care: patient activities, colonies and family placements, chronicity in asylums, incurable lunatics, and the first open-door services; (3) the law of 1838 and its projects of reform: the respective roles of administrative and judicial authorities, private establishments and religious hospitals, the integration in the law of open-door services and outpatient follow-up after 1945.DiscussionIn the 19th century, the economic value of the patients’ work (generally agricultural) was put forth and took precedent, over its therapeutic function. After 1880, the great debates over several months and sessions ceased to deal with specific forensic themes. At the end of the 19th century and the beginning of the 20th, the prevalence of degeneracy and the theses about criminals of the Italian Cesare Lombroso eclipsed the philanthropic concerns of the previous period. During the years just prior to World War I, the theme of responsibility is treated in other forums than by the SMP. After the Second World War, mortality due to starvation in asylums for lunatics was only slightly alluded to.ConclusionIn the ideological context of the period in which they were published, decisive contributions were made between 1852 and 1946 by the SMP in several domains, and which will have a bearing on psychiatric legislation and care up to the present day: on the one hand, the organization of hospital services for the mentally ill patients, occupational therapy, forms of outpatient follow-up care, the beginnings of a sectorial organization of care and ergotherapy in the institutions. On the other hand, criminology, knowledge about dangerous behavior and the responsibility of psychiatric patients, and in forensic expertise.     

收容精神病人治疗中的伦理问题

“收容精神病人”是指政府管理部门收容并送来医院救治的精神病患者。对于收容精神病人的治疗,医院应当坚持社会效益第一、病人利益至上的原则,按人道主义精神,精心治疗。同时,政府应该在立法上予以重视。社会各界的帮助、公安、民政部门的配合参与,有利于此项工作开展。家属必须善待精神病人。