背景:关于精神卫生中强制承诺护理(CCC)的法律,针对酒精和/或药物依赖或滥用问题的成年人的社会和刑事立法旨在解决与物质使用障碍有关的不同情况。本研究探讨了欧洲各州的此类CCC法律在法律权利方面的差异,正式的决定命令和非自愿入学标准,并评估三个法律框架(刑事,精神和社会法)同样很好地确保了人权和公民权利。
方法:三十九定律,来自38个国家,进行了分析。受访者在基于网络的调查表中回答了以下问题:a)在承诺程序中,法律权利向人们提供了物质使用问题,b)正式申请的来源,c)决定录取的实例,d)根据有关法律,36种不同的标准是否可以作为对CCC作出决定的依据。在双变量交叉列表中进行a-c分析。根据主成分分析(PCA)将36项入院标准按标准组进行排序。调查是否合法的权利,决策机构或法律标准可以区分CCC的法律类型,进行判别分析(DA)。
结果:关于CCC的三种类型的法律之间几乎没有区别,涉及个人所享有的法律权利。然而,一些CCC法律似乎仍然缺乏对非法拘留权利的适当保障,无论法律类型。法院是80%法律的决策机构,但这在法律类型之间明显不同。CCC的标准也因法律类型而异,即关于谁应该受到治疗:受扶养罪犯,有行为或攻击行为的物质使用问题的人,或其他有酒精或毒品问题的弱势群体。
结论:该研究提出了有关有关物质使用障碍或滥用问题的各种欧洲CCC法律是否符合国际批准的人权和公民权利公约的问题。这个,然而,适用于所有三种类型的法律,即社会,心理健康和刑事立法。法律类型之间的主要区别在于法律标准,反映了不同的国家优先事项对CCC隐含的野心-进行纠正,为了预防,或支持那些最需要照顾的人。
BACKGROUND: Laws on compulsory commitment to care (CCC) in mental health, social and criminal legislation for adult persons with alcohol and/or drug dependence or misuse problems are constructed to address different scenarios related to substance use disorders. This study examines how such CCC laws in European states vary in terms of legal rights, formal orders of decision and criteria for involuntary admission, and assesses whether three legal frameworks (criminal, mental and social law) equally well ensure human and civil rights.
METHODS: Thirty-nine laws, from 38 countries, were analysed. Respondents replied in web-based questionnaires concerning a) legal rights afforded the persons with substance use problems during commitment proceedings, b) sources of formal application, c) instances for decision on admission, and d) whether or not 36 different criteria could function as grounds for decisions on CCC according to the law in question. Analysis of a-c were conducted in bivariate cross-tabulations. The 36 criteria for admission were sorted in criteria groups based on principal component analysis (PCA). To investigate whether legal rights, decision-making authorities or legal criteria may discriminate between types of law on CCC, discriminant analyses (DA) were conducted.
RESULTS: There are few differences between the three types of law on CCC concerning legal rights afforded the individual. However, proper safeguards of the rights against unlawful detention seem still to be lacking in some CCC laws, regardless type of law. Courts are the decision-making body in 80 % of the laws, but this varies clearly between law types. Criteria for CCC also differ between types of law, i.e. concerning who should be treated: dependent offenders, persons with substance use problems with acting out or aggressive behaviors, or other vulnerable persons with alcohol or drug problems.
CONCLUSIONS: The study raises questions concerning whether various European CCC laws in relation to substance use disorder or misuse problems comply with international ratified conventions concerning human and civil rights. This, however, applies to all three types of law, i.e. social, mental health and criminal legislation. The main differences between law types concern legal criteria, reflecting different national priorities on implicit ambitions of CCC - for correction, for prevention, or for support to those in greatest need of care.