1. Workstream IV — Opportunities and challenges of self-binding directives

    ‘Self-binding directives’ (SBDs) are a special type of advance directive that have been discussed rarely in German-speaking countries. The special feature of this directive is that it allows mental health service users to determine in advance for certain future situations when they wish other people (e.g. relatives or psychiatric professionals) to intervene in their actions.

    Such SBDs could be particularly relevant for people with bipolar disorder, as people with this mental disorder sometimes harm themselves during manic episodes or make decisions that they would not have wanted to make in this way during more stable phases (e.g. spending large sums of money). In such situations, some people with bipolar disorder may, in retrospect, wish that intervention had occurred earlier, if necessary even with the use of coercion.

    In this project area, we will investigate the views on SBDs of people with bipolar disorder, relatives and mental health professionals using interviews and a survey. We will compare the study results from Germany with experiences of our co-operation partners in Great Britain and the Netherlands – a country where SBDs are used based on an explicit legal regulation – and identify ethical challenges and opportunities for the implementation of SBDs in Germany.

    Co-operation partners in this project area are the department “Metamedica” at the VU Medical Centre in Amsterdam, the research group “Mental Health, Ethics and Law” at King’s College in London and the German Association for Bipolar Disorders (DGBS).