Under the auspices of/Sous l'égide de - International Academy of ...

254.4. Strengthening the Patients’ Position: Patients’ Advocacy in Austrian PsychiatriesElke Beermann, Association for Guardianship and Patients`Advocacy, Vienna, Austria(elke.beerman@vsp.at)In 1991 a new commitment law in Austria established a new profession: the Austrian patients` advocacy.This branch of the “Association for Guardianship and Patients` Advocacy” has two main tasks: to representall committed psychiatric indoor patients at court, and to support them in their communication with thehospital staff members. The patients` advocacy is subsidized by the ministry of justice and is independentof the psychiatric hospitals and wards.After a short survey of the Austrian psychiatric landscape information will be given regarding the patients`rights and the legal frame of the commitment law with the patients´ advocates function.The 40 patients` advocates in Austria can refer to an experience of yearly about 12000 interviews withpsychiatric patients within the first days of commitment (“first interviews”) and 12000 court hearings ayear. Focus will be laid on commitment, further coercive measures and medical treatment.The patients´ advocacy does networking aiming to bring forward the exchange of the different points ofviews of judges, psychiatrists and other experts. On the other hand the networking helps patients and theirrelatives to express their points of view to the experts. Networking deepens transparency in psychiatry andhas an increasing impact through professional handling of complaints, for example against disregard andincursions.The Austrian patients` advocacy works at the interface of law and mental health and tries to reduce the gapbetween these two necessary, old and powerful social systems on behalf of psychiatric patients and theirnext of kin.4.5. A Madness for Identity: Psychiatric Labels, Consumer Autonomy, and the Perilsof the InternetLouis C. Charland, University of Western Ontario (charland@uwo.ca)Psychiatric labelling has been the subject of considerable ethical debate. Much of it has centered on issuesassociated with the application of psychiatric labels. In comparison, far less attention has been paid toissues associated with the removal of psychiatric labels. Ethical problems of this last sort tend to revolvearound identity. Many sufferers are reticent to relinquish their iatrogenic identity in the face of official labelchange. Some actively resist it. New forms of this resistance are taking place in the private chat rooms andvirtual communities of the internet; a domain where consumer autonomy reigns supreme. Medicalsociology, psychiatry, and bioethics have paid little attention to these developments. Yet these newconsumer-driven initiatives actually pose considerable risks to consumers. They also present complexethical challenges for researchers. Clinically, there is even sufficient evidence to wonder whether theinternet may be the nesting ground for a new kind of identity disturbance. The purpose of the presentdiscussion is to survey these developments and identify potential issues and problems for future research.Taken as a whole, the entire episode suggests that we may have reached a turning point in the history ofpsychiatry where consumer autonomy and the internet are now powerful new forces in the ‘manufacture ofmadness’.