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TUCSON, Ariz., June 12, 2019 / PRNewswire / – Moral Perceptions of Physicians Regarding the Stress on the Treatment Methods That They Receive in Physician Health Programs (PHP) and "Physicians' Preferred Treatment Programs" May Result in a Moral Injury and a risk of suicide. psychiatrist Robert Emmons, M.D., in the summer issue of Journal of American Physicians and Surgeons.
Originally intended for addiction physicians to recover and return to work, PHP is now used to draw up a long list of supposedly altered mental disorders, writes Dr. Emmons. The formerly collegial clinical process has in many cases become a contradictory legal process. Exclusive referral relationships and often unregulated financial links now link the advice of licensed physicians, hospital peer review panels, PHP and physician treatment programs to a "Medical Regulatory Therapeutic Complex" (MRTC).
Compliance with treatment orders, often in remote and extremely expensive hospitals, is imposed by the threat of loss of license. Patients who face a civil commitment for psychiatric treatment have their civil rights protected. In contrast, MRTC leaders claim that physicians knowingly agree to conduct mental health screening essentially at the will of the medical advice when they apply for their license.
MRTC leaders deny that current practices in their field are tantamount to coercive treatment, although this is the usual perception of physician-oriented PHP treatment patients. Doctors disappointed with their expectations of trusted clinical relationships in what they mistakenly believe to be ordinary treatment situations may feel a sense of betrayal and hurt feelings, which can lead to despair, to wait for exploitation and suicidal ideation.
In ordinary, non-coercive clinical settings, patients who receive bad advice or who simply do not agree with evaluators or treatment agents may escape seeking a second opinion. In the MTC, medical patients are not allowed to refuse to accept a false positive diagnosis, unnecessary care, unsatisfactory treatment or bad faith practice. Even when MRTC practitioners adhere to their own best practice guidelines, the difference between what they deem necessary to protect the public and physicians' expectations of ordinary clinical ethical standards is enough to create the conditions for a better practice. moral injury.
Although it may be difficult to prove or disprove the causal links between practices within the MRTC and the risk of specific adverse events, limited evidence suggesting a high risk of suicide among Doctors mandated in these programs are enough, says Dr. Emmons, to compel immediate action to try to avoid catastrophic and unacceptable events. For any physician mandated for evaluation or treatment in CTRL, the risk of suicide should be reassessed regularly. A thorough and independent inquiry into the practices within the MTC is essential when questions about safety and effectiveness arise. on a treatment imposed on reluctant patients.
Ethical guidelines for the use of coercion in MRTC are proposed. At the same time, "lawyers representing physicians must understand the clinical risks and ethical issues inherent in forced treatment and assessment of fitness for work within the MRTC before advising their clients on their Responses to the Mandates of Licensing Offices and Other Referees "Emmons writes. Physicians who perceive mental illness per se or who have signs of disability should consider requesting assessment and treatment outside the health center.
the Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians of all specialties since 1943.
SOURCE Association of American Physicians and Surgeons (AAPS)
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