A famous anthology of poetry steals its title from Montaigne: ‘I have gathered a posy of other men's flowers; only the string that binds them is mine own' (Reference WavellWavell, 1944). This is a typical joke of Montaigne's for, as the preface to Green & Bloch's anthology reminds us, the word anthology itself comes from the Greek word for flower. So Green & Bloch have put together a collection of papers relating to psychiatric ethics that, for them, presumably represent the flower of literature on this subject.
As the editors themselves comment, the publication of this book is a notable development in itself. The first textbook of psychiatric ethics was published only 25 years ago and, as most will know, Sidney Bloch was its co-editor. Now, Bloch's textbook is in its third edition, and psychiatric ethics has become an academic discourse in its own right. It is now a field for empirical study, with journals publishing high-quality ethical debate, both conceptual and clinical. Clinical relevance is fundamental in psychiatric ethics because values, beliefs and attitudes are not only essential to ethical reasoning, but are also key to understanding a person's mental health and disorder. So an ordinary psychiatric practitioner is likely to meet major ethical dilemmas almost daily.
We need to educate ourselves about psychiatric ethics, and this book is an excellent collection which will be both helpful and useful to those who have to deliver the new MRCPsych curriculum (which requires trainees to be competent ethically). I thought the selection of papers excellent and practical. The section on boundary violations is particularly good and includes a paper which discusses the ethical duties of psychiatrists employed by the state. As a transcript of a conference which took place nearly 30 years ago, it is oddly comforting to find that the principles and arguments are no different, which suggests to me that the ‘two hats’ problem really is an ethically painful one.
I would suggest that anyone who is interested in psychiatric ethics should buy this book; and certainly anyone who is involved in teaching juniors. It is a big book, and the print is horribly small: but it is worth it.
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