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Nursing Ethics, Vol. 11, No. 5, 472-478 (2004)
DOI: 10.1191/096973304ne725oa
© 2004 SAGE Publications

Patient Rights and Law: tobacco smoking in psychiatric wards and the Israeli Prevention of Smoking Act

Ilya Kagan

Tel-Aviv University and Assaf-Harofeh Medical Center, Israel, kaganily{at}post.tau.ac.il, kagani{at}asaf.health.gov.il

Ronit Kigli-Shemesh

Tel-Aviv University and Ness-Ziona Mental Health Center, Israel

Nili Tabak

Tel-Aviv University, Israel

Moshe Z Abramowitz

Eitanim-Kfar Shaul Mental Health Center, Jerusalem, Israel

Jacob Margolin

Eitanim-Kfar Shaul Mental Health Center, Jerusalem, Israel

In August 2001, the Israeli Ministry of Health issued its Limitation of Smoking in Public Places Order, categorically forbidding smoking in hospitals. This forced the mental health system to cope with the issue of smoking inside psychiatric hospitals. The main problem was smoking by compulsorily hospitalized psychiatric patients in closed wards. An attempt by a psychiatric hospital to implement the tobacco smoking restraint instruction by banning the sale of cigarettes inside the hospital led to the development of a black market and cases of patient exploitation in return for cigarettes. This article surveys the literature dealing with smoking among psychiatric patients, the role of smoking in patients and the moral dilemmas of taking steps to prevent smoking in psychiatric hospitals. It addresses the need for public discussion on professional caregivers’ dilemmas between their commitment to uphold the law and their duty to act as advocates for their patients’ rights and welfare.

Key Words: ethics • patients • prevention • psychiatric wards • tobacco smoking


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