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Abstract：
In mental health and psychiatric care, the use of involuntary psychiatric treatment for people with mental disorders is still a central and contentious issue. The main objective of this scoping review was to map and systematize the literature on ethical issues in clinical decision-making about involuntary psychiatric treatment. Five databases (Embase, PsycINFO, CINAHL, Medline, and Scopus) were searched for articles on this topic. Out of a total of 342 articles found, 35 studies from 14 countries were included based on the selection criteria. The articles were analyzed using the inductive content analysis approach. The following main categories were identified: (1) ethical foundations that guide clinical decision-making; (2) criteria for involuntary psychiatric treatment; (3) gaps, barriers, and risks associated with involuntary psychiatric treatment; (4) strategies used to reduce, replace, and improve the negative impact of involuntary treatment; and (5) evidence-based recommendations. Most of the selected articles discuss the logic underlying involuntary treatment of the mentally ill, exploring ethical principles such as autonomy, beneficence, non-maleficence, or justice, as well as how these should be properly balanced. During the process of involuntary psychiatric admission, there was a notable absence of effective communication and a significant power imbalance that disenfranchised those seeking services. This disparity was further intensified by professionals who often use coercive measures without a clear decision-making rationale and by family members who strongly depend on hospital admission. Due to the pluralistic and polarized nature of opinions regarding legal capacity and the complexity and nuance of involuntary admission, further studies should be context-specific and based on co-production and participatory research.
摘要：
在心理健康和精神护理方面，对精神障碍患者使用非自愿精神病治疗仍然是一个核心和有争议的问题。这项范围审查的主要目的是绘制和系统化有关非自愿精神病治疗的临床决策中有关伦理问题的文献。五个数据库(Embase，PsycINFO,CINAHL,Medline,和Scopus）搜索了有关此主题的文章。在总共找到的342篇文章中，根据选择标准，纳入了来自14个国家的35项研究。文章采用归纳内容分析法进行分析。确定了以下主要类别：（1）指导临床决策的道德基础；（2）非自愿精神病治疗的标准；（3）差距，障碍,以及与非自愿精神病治疗相关的风险；(4)用于减少，替换,改善非自愿治疗的负面影响；(5)循证建议。大多数选定的文章讨论了非自愿治疗精神病患者的逻辑，探索自治等伦理原则，仁慈,非恶意,或者正义，以及这些应该如何适当平衡。在非自愿精神病患者入院的过程中，明显缺乏有效的沟通和严重的权力不平衡，剥夺了寻求服务的人的权利。经常在没有明确决策理由的情况下使用强制措施的专业人员以及强烈依赖住院的家庭成员进一步加剧了这种差距。由于关于法律行为能力的意见的多元性和两极分化性质以及非自愿承认的复杂性和细微差别，进一步的研究应针对具体情况，并基于联合制作和参与式研究。
