The attitudes of mental health professionals towards patients’ desire for children

BMC Medical Ethics

Thomas Becker¹  Reinhold Kilian¹  Gisela Badura-Lotter²  Carmen Checchia¹  Silvia Krumm¹ 

[1] Ulm University, Department of Psychiatry II, Bezirkskrankenhaus Guenzburg, Ludwig-Heilmeyer-Str. 2, 89312 Guenzburg, Germany;Ulm University, Institute of the History, Philosophy and Ethics of Medicine, Frauensteige 6, 89075 Ulm, Germany

关键词: Reproductive autonomy;    Desire for children;    Normative orientations;    Mental health professionals;   

Others  :  799574
DOI  :  10.1186/1472-6939-15-18

 received in 2013-05-13, accepted in 2014-02-27,  发布年份 2014

【 摘 要 】

Background

When a patient with a serious mental illness expresses a desire for children, mental health professionals are faced with an ethical dilemma. To date, little research has been conducted into their strategies for dealing with these issues.

Methods

Seven focus groups with a total of 49 participants from all professional groups active in mental health (nurses, psychologists, social workers and psychiatrists) were conducted in a 330-bed psychiatric hospital. Group discussions were transcribed verbatim and analysed by the documentary method described by Bohnsack.

Results

Mental health professionals did not feel that their patients’ desire for children was as important in daily practice as were parenting issues. When discussing the desire for children on the part of patients, the following themes emerged: “the patient’s own decision”, “neutrality”, “the patient’s well-being”, “issues affecting the children of mentally ill parents” and “appropriate parenthood”. In order to cope with what they perceived as conflicting norms, mental health professionals developed the following (discursive) strategies: "subordination of child welfare", "de-professionalisation", "giving rational advice" and "resignation".

Conclusions

The theme of “reproductive autonomy” dominated mental health professionals’ discourse on the desire for children among psychiatric patients. “Reproductive autonomy” stood in conflict with another important theme (patient’s children). Treating reproductive issues as taboo is the result of the gap between MHPs’ perceptions of (conflicting) norms when dealing with a patient’s desire for children and the limited opportunities to cope with them appropriately.

In order to support both patients with a desire for children and mental health professionals who are charged with providing counselling for such patients, there is a need to encourage ethical reflection and to focus on clinical recommendations in this important area.

【 授权许可】

   
2014 Krumm et al.; licensee BioMed Central Ltd.

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