精神科特殊的醫病關係與治療模式，使得精神醫療倫理較其他醫療專科更為強調。本文由精神醫療的歷史與濫用、反精神醫學及醫病關係出發，回顧精神科臨床常見的倫理議題，包括：行為能力、權益維護、病人自主、強制住院、隱私保護、資源重置、知情同意、違反醫病界線、大腦生理操作與精神醫學研究倫理、國外精神醫學倫理宣言，及台灣的精神衛生法，最後並討論精神衛生倫理在本土應用的常見課題。我們建議醫學倫理的「行善益人」、「切勿傷害」、「病人自主」、「公平正義」四大原則，在本土精神醫療上一樣要重視。
For the special doctor-patient relationships and therapeutic models, the psychiatric ethics are more important than other medical disciplines. This paper reviews the psychiatric history and psychiatric misuse, as well as describes the ethic issues in psychiatry which include: doctor-patient relationships, competence, advocacy, autonomy, involuntary admission, confidentiality, resource relocation, informed consent, boundary violation, physical manipulation of the brain, psychiatric research ethics, international ethical declarations and Taiwan mental health law. The differences in the context of the psychiatric ethics in Chinese culture are discussed also. In summary, we suggest all the principal of beneficence, principal of nonmaleficence, principal of autonomy, and principal of justice should be emphasized in the indigenous practice of psychiatry.
