Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-18T05:47:33.848Z Has data issue: false hasContentIssue false

62 - Psychiatric ethics

Published online by Cambridge University Press:  30 October 2009

Sidney Bloch
Affiliation:
Professor University of Melbourne Australia
Stephen A. Green
Affiliation:
Clinical Professor Georgetown University Hospital USA
Peter A. Singer
Affiliation:
University of Toronto
A. M. Viens
Affiliation:
University of Oxford
Get access

Summary

Mrs. J, a 22-year-old secretary, began to exhibit restlessness, perplexity, and remoteness from her husband, Mr. K, following the birth of her first baby 10 weeks earlier. A psychiatrist was summoned after she had visited several neighbors without obvious purpose. He found a reticent, detached woman complaining that, “They have been out to get me from the beginning,” and alluding to “world famine and starving children.” Mental status examination revealed vague, paranoid thinking but firm denial of suicidal and homicidal impulses; she was not obviously delirious. Mrs. J resisted the psychiatrist's recommendation that she be admitted to the local psychiatric hospital. Mr. K supported her in this, insisting that he did not regard his wife as mentally ill and feared she would deteriorate if placed alongside genuinely disturbed patients.

What is psychiatric ethics?

Psychiatric ethics is concerned with the application of moral rules to situations and relationships specific to the field of psychiatry. Resolution of ethical dilemmas confronting psychiatrists, as illustrated by the above case, requires deliberation grounded in a moral theoretical framework that provides methods and justifications for clinical decision making. An outline of such theories is covered in the introductory chapter of the book. We will focus exclusively on ethical aspects of clinical practice that are especially challenging to psychiatrists and briefly offer a preferred theoretical framework to deal with them.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric AssociationM (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington DC: American Psychiatric Press.Google Scholar
Aponte, H. J. (1985). The negotiation of values in therapy. Fam Process 24: 323–38.CrossRefGoogle ScholarPubMed
Appelbaum, P. (1988). The right to refuse treatment with antipsychotic medications: retrospect and prospect. Am J Psychiatry 145: 413–19.Google ScholarPubMed
Appelbaum, P. and Gutheil, T. (1979). “Rotting with their rights on”: constitutional theory and clinical reality in drug refusal by psychiatric patients. Bull Am Acad Psychiatry Law 7: 308–17.Google ScholarPubMed
Baier, A. (1985). Postures of the Mind. Minneapolis, MN: University of Minnesota Press.Google Scholar
Baier, A. (2004). Demoralization, trust and the virtues. In Setting the Moral Compass, ed. Calhoun, C.. New York: Oxford University Press, pp. 176–88.Google Scholar
Beahrs, J. and Gutheil, T. (2001). Informed consent in psychotherapy. Am J Psychiatry 158: 4–10.CrossRefGoogle ScholarPubMed
Beauchamp, T. and Childress, J. (2001). Principles of Biomedical Ethics, 5th edn. New York: Oxford University Press.Google Scholar
Bergin, A. (1980). Psychotherapy and religious values. J Consult Clin Psychol 48: 95–105.CrossRefGoogle ScholarPubMed
Bloch, S. and Pargiter, R. (2002). A history of psychiatric ethics. Psychiatr Clin North Am 25: 509–24.CrossRefGoogle ScholarPubMed
Cesarani, D. (1998). Arthur Koestler: The Homeless Mind.London: William Heineman.Google Scholar
Chesler, P. (1972). Women and Madness. New York: Avon Books.Google Scholar
Chodoff, P. (1984). Involuntary hospitalisation of the mentally ill as a moral issue. Am J Psychiatry 141: 384–9.Google Scholar
Donaldson v. O'Connor F. (1974). 2d 5th Cir, decided April 26.
Dyer, A. and Bloch, S. (1987). Informed consent and the psychiatric patient. Journal of Medical Ethics 13: 12–16.CrossRefGoogle ScholarPubMed
Engelhardt, H. T. (1973) Psychotherapy as meta-ethics. Psychiatry 36: 440–5.CrossRefGoogle ScholarPubMed
Freud, S. (1924). Recommendations to Physicians Practising Psychoanalysis, standard edn 12. London: Hogarth Press, pp. 111–20.Google Scholar
Freud, S. (1937). Analysis Terminable and Interminable, standard edn 23. London: Hogarth Press, pp. 211–53.Google Scholar
Goldberg, C. (1977). Therapeutic Partnership: Ethical Concerns in Psychotherapy.New York: Springer.Google Scholar
Gray, J. (ed.) (1976). John Stuart Mill on Liberty. Oxford: Oxford University Press.Google Scholar
Green, S. and Bloch, S. (eds.) (2006). An Anthology of Psychiatri Ethics. Oxford: Oxford University Press, pp. 93–8.Google Scholar
Halasz, G. (2002). A symposium of attention deficit hyperactivity disorder (ADHD): an ethical perspective. Aust NZ J Psychiatry 36: 472–5.CrossRefGoogle Scholar
Holmes, J. (1996). Values in psychotherapy. Am J Psychother 50: 259–73.CrossRefGoogle ScholarPubMed
Kaplan, M. (1983). A woman's view of DSM-III. Am Psychol 38: 786–92.CrossRefGoogle ScholarPubMed
Klerman, G. (1990). The psychiatric patient's right to effective treatment: implications of Osheroff v. Chestnut Lodge. Am J Psychiatry 147: 419–27.Google ScholarPubMed
Kramer, P. (1993). Listening to Prozac.New York: Viking.Google Scholar
Laing, R. (1969). The Divided Self. New York: Pantheon Books.Google Scholar
Laing, R. (1970). Sanity, Madness and the Family. New York: Penguin Books.Google Scholar
Lidz, C. W., Meisel, A., Zerubavel, E., et al. (1984). Informed Consent: A Study of Decision Making in Psychiatry.New York: Guilford.Google Scholar
Munetz, M., Galon, P., and Frese, F. (2003). The ethics of mandatory community treatment. J Am Acad Psychiatry Law 31: 173–83.Google ScholarPubMed
O'Connor v. Donaldson (1975). 422US. 563.
Reich, W. (1999) Psychiatric diagnosis as an ethical problem. In Psychiatric Ethics, 3rd edn, ed. Bloch, S., Chodoff, P., and Green, S.. Oxford: Oxford University Press, pp. 193–224.Google Scholar
Roberts, L. (2002). Informed consent and the capacity for voluntarism. Am J Psychiatry 159: 705–12.CrossRefGoogle ScholarPubMed
Rogers v. Okin (1979) 478 F Supp 1342 (D Mass).
Rogers v. Commissioner of the Department of Mental Health (1983) 458NE 2d 308 (Mass Sup Jud Ct).
Scheff, T. (1966). Being Mentally Ill: A Sociological Theory. Chicago, IL: Aldine.Google Scholar
Steere, J. and Dowdall, T. (1990). On being ethical in unethical places: the dilemma of South African clinical psychologists. Hastings Cent Rep 20: 11–15.CrossRefGoogle Scholar
Stoller, R., Marmor, J., Beiber, I., et al. (1973). A symposium: should homosexuality be in the APA nomenclature. Am J Psychiatry 130: 1207–16.CrossRefGoogle ScholarPubMed
Stone, A. (1981). The right to refuse treatment: why psychiatrists should and can make it work. Arch Gen Psychiatry 38: 358–62.CrossRefGoogle ScholarPubMed
Stone, A. (1990). Law, science, and psychiatric malpractice: a response to Klerman's indictment on psychoanalytic psychiatry. Am J Psychiatry 147: 419–27.Google ScholarPubMed
Szasz, T. (1960). The myth of mental illness. Am Psychol 15: 113–18.CrossRefGoogle Scholar
Szasz, T. (1986). The case against suicide prevention. Am Psychol 41: 806–12.CrossRefGoogle ScholarPubMed
Staden, C. and Kruger, C. (2003). Incapacity to give informed consent owing to mental disorder. Journal of Medical Ethics 29: 41–3.CrossRefGoogle ScholarPubMed
Wakefield, J. (1992). The concept of mental disorder: on the boundary between biological facts and social values. Am Psychol 47: 373–88.CrossRefGoogle ScholarPubMed
World Health Organization (1992). International Statistical Classification of Diseases and Related Health Problems, 1989 Revision. Geneva: World Health Organization.
Wyatt v. Stickney (1971) 325 F Supp 781.
Wyatt v. Stickney (1972) 344 F Supp 373, 376, 379–385.

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Psychiatric ethics
  • Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
  • Book: The Cambridge Textbook of Bioethics
  • Online publication: 30 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545566.072
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Psychiatric ethics
  • Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
  • Book: The Cambridge Textbook of Bioethics
  • Online publication: 30 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545566.072
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Psychiatric ethics
  • Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
  • Book: The Cambridge Textbook of Bioethics
  • Online publication: 30 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545566.072
Available formats
×