Self-binding directives (SBDs) are a special type of psychiatric advance directive by means of which mental health service users can give advance consent to compulsory hospital admission or treatment during a future mental health crisis. SBDs are legally binding in the Netherlands since 2008. On the 1st of January 2020, the Dutch Law on Special Admissions to Psychiatric Hospitals (Wet bijzondere opnemingen in psychiatrische ziekenhuizen; Bopz) was replaced by the new Law on Compulsory Mental Health Care (Wet verplichte geestelijke gezondheidszorg; Wvggz). This replacement brought with it various changes in the legal arrangement for SBDs. In this article, we expound the changes in the legal arrangement and assess the implications of these changes for the practical feasibility of SBDs. We argue that the procedures for arranging compulsory care based on an SBD in the new law are too complex and time-intensive for SBDs to yield their potential benefits. We close by proposing a workable mechanism of legal authorisation of compulsory care on the basis of an SBD.

自我约束性指令 (SBD) 是一种特殊类型的精神病学预先指令，精神卫生服务使用者可以通过它预先同意在未来的精神健康危机期间强制入院或接受治疗。自 2008 年以来，SBD 在荷兰具有法律约束力。 2020 年 1 月 1 日，荷兰精神病医院特殊入院法 ( Wet bijzondere opnemingen in psychiatrische ziekenhuizen ; Bopz) 被新的强制性精神保健法 ( Wet verplichte) 取代geestelijke gezondheidszorg; Wvggz)。这种替换为 SBD 的法律安排带来了各种变化。在本文中，我们阐述了法律安排的变化，并评估了这些变化对 SBD 的实际可行性的影响。我们认为，新法律中根据 SBD 安排强制护理的程序过于复杂和耗时，SBD 无法产生其潜在利益。最后，我们提出了一个基于 SBD 的强制医疗合法授权的可行机制。