Reasons for endorsing or rejecting self-binding directives in bipolar disorder: a qualitative study of survey responses from UK service users

The Lancet Psychiatry

Fecha de publicación: Mayo de 2021

Autores: Preety Das, MRCPsych ^†, Gareth Owen, PhD, Lucy Stephenson, MRCPsych, Larry Rifkin, MRCPsych, Guy Hindley, MBBS, Prof John Dawson, LLD, Alex Ruck Keene, MA

DOI: https://doi.org/10.1016/S2215-0366(21)00115-2

Background: Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having the potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, the views of service users on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human rights.