Bioethical Conditions in Common Decisions for Advance Directives in Psychiatry

Abstract

Introduction. The Advance Directives in Psychiatry (ADP) are embed- ded in the Convention on the Rights of Persons with Disabilities and in the legal norm as constituents of the right of individuals to have sup- port mechanisms in advance decisions about their health, which call for a change from the paternalistic care position to that of accompaniment in decision-making in mental health care. This change requires several transformations for ADPs to become a reality. Bioethics can make the application of ADP viable. Objective. Recognize the bioethical conditions that facilitate supported decision-making as part of the execution of the ADP. Method. A participant observation was conducted in two psychiatric inpatient departments, between June and September 2022. Results. Through a thematic analysis, three themes were obtained: clinical care, patient predisposition and medical-legal issues. This study considered only a part of theme 2 with its subthemes: Self-perception of patients, negotiation, and family. Discussion and conclusion. The self-perception of patients, the negotiation they do with doctors and the family involvement of people with mental conditions are bioethical conditions that facilitate common decision-making and with it, the implementation of ADP.