Ethics Council hears experts concerning "benevolent coercion" in child and youth services as well as in nursing and services for the disabled
The German Ethics Council is currently preparing an Opinion on what role coercive measures play in fields of practice such as psychiatry, nursing, social work, child and youth services as well as services for the disabled; to what extent this is ethically and legally problematic; and what need for change exists in practical fields and their legal regulation. In focus for the Ethics Council are those coercive measures that are conducted against the will of the affected persons ("self-determination") on the grounds of their self-protection (so-called benevolent coercion).
The object of the hearing on 18 May will be coercive measures that are applied in child and youth services, for example in the form of liberty-depriving measures, but also in the guise of forced medication and other coercive treatments, contact bans as well as the use of reward and punishment systems and similar restrictive pedagogical measures. In the course of the hearing, the German Ethics Council would like to enquire about experiences with forms of benevolent coercion in child and youth services; discuss the state of research in this area; and debate measures for promoting the self-determination of children and adolescents as well as control mechanisms for coercive measures and possible alternatives. The German Ethics Council will gather expertise from educational science, law, administrative practice and sample institutions, but will also survey affected youths. For the protection of the affected persons, their consultation will not take place publicly.
The hearing on 19 May is dedicated to coercive measures in nursing and services for the disabled to which mainly persons with high requirements for support and/or care are exposed. Particularly very old and severely ill persons, as well as those with severe physical or cognitive disabilities, are affected in these areas by measures such as forced care; involuntary commitment in homes for persons with disabilities or in nursing homes; measures restricting freedom; diagnostic and therapeutic coercive measures; measures for care conducted under compulsion, for instance, those concerning personal hygiene, intake of food or liquids; as well as reward and punishment systems from behavioural psychology. With the help of the hearing, the German Ethics Council would like to look into the different manifestations of benevolent coercion in nursing and services for the disabled as well as to establish the factors that are decisive for their presence. Since the nursing and care personnel in these areas especially frequently refer to structural conditions in order to legitimize the exercise of coercion, also at stake is the question of how structures can be changed so that certain coercive measures can be abstained from. In the framework of the hearing, experts from rehabilitation pedagogy, general medicine and sample institutions as well as representatives from associations for relatives and for affected persons have a chance to speak.
Previously on 23 February, the Ethics Council addressed forms of coercion in psychiatry in the course of an initial hearing and sought to that end the expertise of persons affected, relatives and professional actors.
Regarding all three fields of practice, moreover, the German Ethics Council is conducting an online survey in which all persons and institutions with an interest in the topic can participate until 31 May 2017.
Further Information (in German):