Psychiatric Ethics Syllabus

Chapter Manuscript, 2017

An overview of the historical sources of ethical reasoning, giving clinical practitioners a structured method for analysis of ethical dilemmas and moral pluralism typically encountered in the practice of psychiatry. This review will appeal to the psychiatric practitioner who is faced with ethical decisions about which reasonable practitioners may and do disagree, while providing tools and sample cases that facilitate the process of analysis and justification of decision-making.

The Canadian Journal of Psychiatry, 1990

This paper critically examines the code of ethics that applies to practising psychiatrists. The code performs the functions for which it was designed admirably well. It does not, however, resolve moral dilemmas (i. e., complex situations in which any course of action compromises certain ethical principles). In these cases, the psychiatrist must turn to wider moral theory (i.e. , psychiatric ethics) for guidance.

Objective: The aim of this paper is to consider the application of principlebased medical ethics to psychiatry. Conclusions: Principles-based medical ethics is a useful tool for resolving ethical dilemmas in psychiatry in that clinical aspects of ethical dilemmas can be better articulated than in other methods. The ethical dilemmas unique to psychiatry, such as those related to impairment of autonomy, present a challenge to the method. After considering a case example, we conclude that psychiatrists can best utilise a principles based approach to ethical dilemmas when they combine this with a level of critical reflection in the light of other ethical theories, such as virtue ethics, as well as close consideration of the clinical and social context of the ethical dilemma.

Harvard Review of Psychiatry, 2008

Psychiatric ethics has emerged as a distinct academic medical discipline. The publication of the third edition of the Oxford University Press textbook Psychiatric Ethics in 1999 and Oxford's publication of An Anthology of Psychiatric Ethics in 2006 have helped to establish psychiatric ethics as a discipline in its own right and to identify core issues facing the field. 1,2 These issues include those relating to confidentiality, professional boundaries, informed consent, involuntary treatment, managed care, and health resource allocation. While these areas remain essential for deliberation, research, and education in contemporary psychiatry, the scope of psychiatric ethics has been continually widening to include other important domains of our field. This special issue of the Harvard Review of Psychiatry aims to showcase some, but by no means all, of both the long-standing and the novel subjects facing psychiatric ethics in the twenty-first century. The articles in this issue make clear that contemporary psychiatric ethics must draw upon traditional principles of biomedical ethics but supplement these principles with diverse new considerations, approaches, and forms of reasoning. Nowhere is the need for fresh ethical reasoning more essential than in biological psychiatry. The genomics revolution in biomedical research, in general, has had a profound impact on the focus and tasks of psychiatric research, in particular. With an explosion of research on genetic contributions to psychiatric illness and early success in identifying important candidate genes, the urgency of ethical reflection on this form of investigation has intensified. Recent articles in the medical and public health literature have addressed the multifaceted ethical challenges associated with

This is a review of two volumes in the Oxford Series on Philosophy and Psychiatry.

Australian and New Zealand Journal of Psychiatry, 2005

This is the introductory paper to the special issue on ethics in psychiatry. We introduce the other papers that follow and set them in a context. Inevitably, they represent only a thin slice of the work going on in psychiatric ethics. But they serve to show two unique features of this discipline. First, it has a tendency to dig deep and to make connections with other philosophical concepts. So, for example, in a number of ways the papers that follow touch on the nature of personhood. We examine this notion. Second, psychiatric ethics, because of its content and its embededness in the real world, tends to hit upon diverse and sometimes conflicting values. We introduce the idea of values-based medicine, which provides both a theoretical framework and a practical approach to the common dilemmas of psychiatric practice. The need to think deeply, but also clearly and coherently, combined with the need to engage with the hurly-burly of the world of patients, users and carers, suggests the reasons why psychiatric ethics offers a paradigm for practical ethics generally.

Psychosomatics, 1999

The expanding field of bioethics has created a need in psychiatry for rapid access to the complex bioethics literature. This is especially true in consultation-liaison work. An annotated bibliography was created by a task force of the Academy of Psychosomatic Medicine charged with exploring how psychiatrists function on bioethics committees. The bibliography is organized into headings that reflect how bioethical problems came to the attention of psychiatrists. Introductory references allow the reader an overview of the history of bioethics and a selection of useful textbooks. References are provided explaining how ethical principles are used. References are also organized by areas of medical work frequently visited by consultation-liaison psychiatrists.

 IP Innovative Publication Pvt. Ltd, 2017

Ethical choices, both minor and major, confront us every day in the provision of health care for persons with diverse values living in a pluralistic and multicultural society. Several sets of principles have been drawn to guide professional behaviour; the earliest being from the 4th century BC, by Hippocrates, directed to physicians “to help and do no harm” in his book “Of the Epidemics”. There is of course no doubt that ethics is much more relevant to psychiatry, as the line of demarcation between normal and abnormal is often hazy and the appropriateness of psychiatric diagnosis and treatment can be easily questioned. For example, in “The Myth of Mental Illness: Foundations of a Theory of Personal Conduct”, a book by Thomas Szasz, in which Szasz criticizes and accuses psychiatry of being a myth. The book quotes, “The problem with psychiatric diagnoses is not that they are meaningless, but that they may be, and often are, swung as semantic blackjacks: cracking the subject's dignity and respectability destroying him just as effectively as cracking his skull”. “Asylums” by Goffman a renowned anti-psychiatry book criticized the mental hospitals and charged that it had a deleterious effect on patients. Understanding these distinct difficulties, the World Psychiatric Association developed a code of ethics in 1977. A committee was appointed by the Indian Psychiatric Society to prepare the code of ethics for the psychiatrists in India. The code was approved at its annual conference in Cuttack in 1989. It has been reviewed by Agarwal and Gupta.

General Hospital Psychiatry, 2000

The growing complexity of medical care and practice has increasingly brought a number of otherwise independent disciplines into closer working relationships for purposes of mutual education and problem solving. This process is prominently visible in the ways law, ethics, and psychiatry intersect around patient care in the general medical and hospital setting. This special section will publish informative and provocative articles which address these vital matters.

World Psychiatry, 2006