Psychiatry Research EG

The Declaration of Hawaii (1) was the first positional statement of the psychiatric profession concerning ethical questions. It was prepared by Clarence Blomquist and was adopted by the General Assembly of the World Psychiatric Association in Hawaii in 1977. Its primary aim was to encourage psychiatrists in conflicts of loyalty in contemporary societies and to help them in conflicts of psychiatric decision-making. A major trigger was the political misuse of psychiatry in countries such as the former Soviet Union, Romania and South Africa, that came to public awareness during the early 1970s. The very first paragraph of the Declaration is concerned with the ethical problem of the political misuse of psychiatric concepts, knowledge and techniques (2). The Declaration of Hawaii explicates the ethical principles of respect for autonomy and of beneficence, by formulating the components of informed consent, by calling to mind the obligation of confidentiality, by stating rules for forensic evaluation and compulsory interventions, by demanding the possibility of independent proof of compulsory measures and by obliging psychiatrists not to misuse their professional possibilities and particularly to abstain from any compulsory intervention in the absence of a mental disorder. The efforts of psychiatrists and health politicians initiated in many countries continued to achieve fundamental improvement of care for the mentally ill. A growing recognition of their fundamental rights led to the United Nations (UN) Resolution 46/119 for the Protection of Persons with Mental Illness and the Improvement of Mental Health Care (Principles for Policy on Mental Health) in 1991 (3). In this resolution, human rights of the mentally ill and their right to treatment were codified for the first time in a UN document. Psychiatrists were meant to use these regulations as a reference vis-à-vis the authorities and governments of their countries. The national governments, for their parts, were to promote the principles of this resolution by means of appropriate legislative, juridical, administrative, educative and other provisions.