Author:

Keywords:

Activities of Daily Living, Bioethical Issues, Caregivers, Community Mental Health Services, Health Policy, Health Services Accessibility, Hospitalization, Humans, Personal Autonomy, Professional-Patient Relations, Quality of Health Care, Social Environment, Social Responsibility, Social Values, 1199 Other Medical and Health Sciences, 1801 Law, 2201 Applied Ethics, Applied Ethics, 5001 Applied ethics

Abstract:

Ethical dilemmas in community mental health care is the focus of this article. The dilemmas are derived from a discussion of the results of a qualitative research project that took place in five countries of the European Union. The different stakeholders are confronted with the following dilemmas: community care versus hospital care (clients); a life with care versus a life without care (informal carers); stimulation of the client toward greater responsibility versus protection against such responsibility (professionals); budgetary control versus financial incentives (policy makers), and respect for the client versus particular private needs (neighbourhood residents). These dilemmas are interpreted against the background of a value based ethical model. This model offers an integral approach to the dilemmas and can be used to determine policy. The dilemmas are discussed here as the result of conflicting values-namely autonomy and privacy, support and safety, justice and participation, and trust and solidarity.