Projects

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ENSURE

Enhancing the Informed Consent Process: Supported decision-making and capacity assessment in clinical dementia research

 

Funding:

ENSURE is funded by the German Ministry for Education and Research (BMBF).

Grant number: 01GP1623B

Duration: 2016-2019

 

Summary:

As a result of an ageing population, the already high number of people suffering from dementia will significantly increase in European countries in the coming decades. For this reason, there is a substantial need for further medical dementia research. People with dementia have the right to decide whether or not they want to participate in clinical research on the basis of their free informed consent. High standards for the informed consent process and the assessment of decision-making capacity are important to protect potential research participants.

ENSURE is an international and interdisciplinary collaboration involving the following project partners:

ENSURE involves researchers from gerontology, psychology, psychiatry, law and medical ethics. The project aims to enhance the capacity to consent of people with dementia, to improve the assessment of decision-making capacity, to protect those who do not have the capacity to consent, and to ensure that the inclusion of people with dementia in neuroscientific and medical research is ethically justifiable. The Bochum subproject focuses on ethical and conceptual questions regarding informed consent and decision-making capacity.

Within the thematic context of ENSURE, Jochen Vollmann and Jakov Gather serve as trustees and Matthé Scholten as an expert of the German Academy for Ethics in Medicine for the AMWF S2 clinical guideline “Informed consent to medical treatment for persons with dementia.”

Jochen Vollmann serves as a member of the working group “Ethics and Law” for the DGPPN S3 clinical guideline “Prevention of and Intervention with Aggressive Behavior.”

 

Researchers:


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HumanMeD

Human rights and mental health: Implementing the United Nations Convention on the Rights of Persons with Disabilities in mental health care - An international and interdisciplinary workshop

 

Funding:

HumanMeD is funded by the German Ministry for Education and Research (BMBF).

Grant number: 01GP1884

Duration: 2018-2020

 

Project description:

The United Nations Convention on the Rights of Persons with Disabilities (CRPD) was adopted by the United Nations General Assembly in 2006 and entered into force in 2008. By now, 177 states parties have ratified the convention. The implementation of the CRPD will have far-reaching consequences for the provision of health care for persons with mental disorders. This workshop brings together early career scholars, experts, policy-makers, service users and other stakeholders from Germany, Ireland and the United Kingdom to critically assess the implementation process of the CRPD in these jurisdictions. The central question it addresses is how the CRPD can be implemented in the context of health care so as to promote the autonomy of persons with mental disorders and guarantee their equal treatment.

The workshop pursues the following aims:

  • Defining the basic concepts and outlining the ethical and legal framework
  • Determining whether the provisions for involuntary commitment and involuntary treatment in the respective jurisdictions constitute discrimination on the basis of disability
  • Assessing the opportunities and risks of supported decision-making
  • Making recommendations for the implementation of the CRPD in the context of mental health care

 

Researchers:


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Psychiatric Advance Directives

Project description:

Advance directives are documents that enable patients to articulate their treatment choices for later periods of incompetence. In psychiatry, advance directives are particularly helpful for service users who suffer from disorders that may entail recurrent phases of temporary incompetence, such as bipolar, depressive and schizophrenic disorders. Psychiatric advance directives can strengthen the autonomy of psychiatric service users and increase their share in medical decision-making. In addition, they can lead to a reduction of involuntary treatment and coercion rates.

The implementation of psychiatric advance directives raises several fundamental ethical concerns. How, for example, should mental health professionals deal with advance directives in which patients indiscriminately reject all forms of psychiatric treatment? Should psychiatric advance directives be revocable at any time or should psychiatric service users have the right to exclude the possibility of revocation under conditions of incompetence?

Besides the ethical questions that arise in the context of advance directives, their implementation in clinical practice also raises several empirical issues. Although many psychiatric service users express interest in advance directives, in practice few of these documents are actually completed. This may be caused by barriers to the implementation of psychiatric advance directives such as limited time resources in psychiatric practice and lack of access to completed directives.

A dissertation project will identify the institutional barriers and difficulties in the implementation process of advance directives. By means of a nationwide quantitative questionnaire, the attitudes, knowledge and experience of psychiatrists with regard to various forms of psychiatric advance care planning will be investigated. The data will be analyzed by means of descriptive statistics.

 

Researchers:

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SALUS (BMBF Research Group)

The ethics of coercion: Striking a balance between autonomy, well-being and security in psychiatric practice

 

Funding:

SALUS is funded by the German Ministry for Education and Research (BMBF) as an independent research group in the field of ethical, legal and social aspects of modern life sciences.

Grant number: 01GP1792

Duration: 2018-2024

The SALUS project is carried out in close cooperation with the Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum.

 

Project desciption:

The use of coercion in the treatment of persons with mental disorders is one of the major ethical controversies in psychiatry. The aim of SALUS is to determine whether considerations of well-being and security can justify coercive interventions and to investigate whether potential conflicts between autonomy, well-being and security can be prevented by considering the latter two values in the advance care planning process. To this end, we will

  • identify consequences of recent autonomy-enhancing policies for the well-being of service users and the security of third parties,
  • examine the attitudes of mental health professionals, service users and the general public toward coercion in psychiatry,
  • determine conditions under which coercive interventions can be morally justified,
  • improve psychiatric advance directives by including considerations of well-being and security in the advance care planning process, and
  • assess and evaluate the opportunities and challenges of self-binding directives.

The SALUS project takes a bottom-up approach in which conceptual and normative analyses are informed by and closely interlinked with qualitative and quantitative empirical research.

 

Researchers:

Project website:

https://bochum-salus-project.com/


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Collaborations

 

Task-Force "Psychiatry and Palliative Medicine"

Deutsche Gesellschaft für Gerontopsychiatrie und -psychotherapie (DGGPP), Deutsche Gesellschaft für Palliativmedizin (DGP) und Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN)

Jochen Vollmann

2017-

 

AMWF S2 Clinical Guideline “Informed consent to medical treatment for persons with dementia”

 Jakov Gather and Jochen Vollmann: respresentative of the AEM and member of the expert and author group

 Astrid Gieselmann and Matthé Scholten: member of the expert and author group

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Past Projects

 

Ethical expertise in clinical practice: An empirical-ethical inquiry into normative competence in value conflicts in psychiatry

FoRUM, Ruhr University Bochum

Researchers: Joschka Haltaufderheide and Jochen Vollmann

2017-2018

 

Winter school: Beneficial coercion in medicine? Foundations, areas of conflict, prevention

German Ministry of Education and Research

Grant program ethical, legal and social aspects of the modern life sciences

Researchers: Jakov Gather, Tanja Henking, Alexa Nossek and Jochen Vollmann

2016-2017

 

Implementation and evaluation of advance directives in the hospital

German Ministry of Education and Research

Grant number: 1711701

Jochen Vollmann

2001-2003

 

Ethicists and Practitioners in Collaboration on Capacity (EPICC)

European Commission

European Fifth Framework

Grant number: QLG6-CT-2001-00037

Jochen Vollmann

2002-2003

 

Empirical studies on competence and the process of informed consent for mentally disordered persons

German Research Foundation (DFG)

Grant number: Vo 625/2-1

Jochen Vollmann

1998-2001

 

Ethical, legal, and social aspects of brain research

European Commission

Biotechnology Program (BIOTECH II)

Grant number: BIOTECH 2B104 CT97 2264

Jochen Vollmann

1997-1999

 

Ethical problems concerning informed consent in health care, as exemplified by persons with dementia

German Research Foundation (DFG)

Grant number: Vo 625/1-3

Jochen Vollmann

1994-1996

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Past collaborations

 

DGPPN S3 Clinical guideline "Prevention und Intervention in case of aggressive behavior"

Menmber for ethics and law

Jochen Vollmann

2015-2018

  

Ex-In

LWL inclusion project: Employment of qualified peer support workers in psychiatric acute hospitals – implementation and ethical evaluation

Ex-In was funded by the Regional Association of Westphalia-Lippe (LWL) and was carried out by the Department of Psychiatry, Psychotherapy and Preventive Medicine of the Ruhr University Bochum. The Institute for Medical Ethics and History of Medicine was a collaboration partner.

Researchers: Jakov Gather, Alexa Nossek and Ina Otte

2015-2017

 

Open doors

Effects of open-door policies in acute psychiatry on coercion and perceived coercion – clinical and ethical aspects

This project is funded by the medical faculty of the Ruhr University Bochum (FoRUM) and was carried out by the Department of Psychiatry, Psychotherapy and Preventive Medicine of the Ruhr University Bochum (Jakov Gather and Georg Juckel). The Institute for Medical Ethics and History of Medicine was a collaboration partner in the qualitative empirical subproject.

Researchers: Jakov Gather and Ina Otte

2016-2017

 

Reduction of coercion

Qualitative interviews with police officers as a part of a state-wide enquiry into the views of all stakeholders in mental health services.

This project was part of the ZWARED project, funded by the Ministry of Health, Equalities, Care and Ageing (MGEPA) of the federal state Nordrhein-Westfalen and carried out by the Department of Psychiatry, Psychotherapy and Preventive Medicine of the Ruhr University Bochum. The Institute for Medical Ethics and History of Medicine was a collaboration partner

Researchers: Jakov Gather and Ina Otte

2016-2017

 

Volkswagen Foundation research project "Enhancement of competence to consent to treatment by means of resource-oriented communication (EmMa)"

Advisory Board

Jochen Vollmann

2011-2017

 

Task Force "Ethics in Psychiatry and Psychotherapy"

German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN)

Chair

Jochen Vollmann

2013-2014

 

Respect for autonomy and the use of coercion with regard to the treatment of mentally disordered persons. A position paper of the DGPPN

German Association for Psychiatry, Psychotherapyand Psychosomatics (DGPPN)

Jochen Vollmann: Chair of the task force “Ethics in Psychiatry and Psychotherapy” and first author

Jakov Gather: Member of the task force “Ethics in Psychiatry and Psychotherapy” and co-author

2012-2014

 

Dementia Ethics Steering Committee

Alzheimer Europe

Jochen Vollmann

2010-2014

 

Medical Ethics Committee of the World Federation of Societies of Biological Psychiatry

Secretary

Jochen Vollmann

2001-2005